Broglie, Larisa
Broglie, Larisa is an individual health care provider with primary practice located at 9000 W Wisconsin Ave Pediatric Bone Marrow Transplant, Milwaukee WI 53226-4874. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology. Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology is her primary health care specialty. Broglie, Larisa can be contacted via phone (414) 266-4850.Contact Information
Primary practice address
9000 W Wisconsin Ave Pediatric Bone Marrow Transplant
Milwaukee WI 53226-4874
Phone: (414) 266-4850
Fax: (414) 266-3682
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 65875 | Wisconsin |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036132018 | Illinois |
| Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology | 2080P0207X | 65875 | Wisconsin |
Profile Details
| NPI number | 1063737013 |
|---|---|
| LBN Legal business name | Broglie, Larisa |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 1st, 2010 |
| Last updated | Jun 22nd, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063737013 | NPPES |
| Wisconsin | MEDICAID | 1063737013 |
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