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:
Health care specialties
| Specialty | Code | License # | 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 10 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 | 1093726473 | NPPES |
| New York | MEDICAID | 01158323 | |
| New York | Other | 8110 | |
| New York | Other | 480007845 |
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