Broccoli, Edward John
Broccoli, Edward John is an individual health care provider with primary practice located at 16 S Bedford Rd 3W, Chappaqua NY 10514-3464. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Broccoli, Edward John can be contacted via phone (914) 844-2864.Contact Information
Primary practice address
16 S Bedford Rd 3W
Chappaqua NY 10514-3464
Phone: (914) 844-2864
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 1934481 | New York |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 1934481 | New York |
Profile Details
| NPI number | 1609866060 |
|---|---|
| LBN Legal business name | Broccoli, Edward John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2005 |
| Last updated | Jan 11th, 2024 - about 11 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609866060 | NPPES |
| New York | Other | 0004487677 | AETNA US HEALTHCARE PPO |
| New York | Other | 5398369 | AETNA US HEALTHCARE PPO |
| New York | Other | 8K819 | AETNA US HEALTHCARE PPO |
| New York | Other | 3129240 | AETNA US HEALTHCARE PPO |
| New York | Other | 5398370 | AETNA US HEALTHCARE PPO |
| New York | Other | P2823545 | AETNA US HEALTHCARE PPO |
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