Broderick, James Edward

Broderick, James Edward is an sole proprietor health care provider with primary practice located at 470 S Pearl St , Canandaigua NY 14424. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as his primary health care specialty. Broderick, James Edward can be contacted via phone (585) 394-4070.

Contact Information

Primary practice address
470 S Pearl St Canandaigua NY 14424
Phone: (585) 394-4070
Fax: (585) 394-8563
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X N004540 New York

Profile Details

NPI number 1093726473
LBN Legal business name Broderick, James Edward
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 10th, 2006
Last updated Nov 22nd, 2016 - about 9 years 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093726473 NPPES
New York MEDICAID 01158323
New York Other 8110
New York Other 480007845

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