Broderick, Kevin J

Broderick, Kevin J is an individual health care provider with primary practice located at 1 Compass Way Suite 102, East Bridgewater MA 02333-1465. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Broderick, Kevin J can be contacted via phone (508) 350-2100.

Contact Information

Primary practice address
1 Compass Way Suite 102 East Bridgewater MA 02333-1465
Phone: (508) 350-2100
Fax: (508) 350-2314
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 204113 Massachusetts

Profile Details

NPI number 1013954759
LBN Legal business name Broderick, Kevin J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2006
Last updated Mar 7th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013954759 NPPES
Massachusetts Other SX3393 MEDICARE PTAN
Massachusetts Other 204113 MEDICARE PTAN
Massachusetts Other 713262 MEDICARE PTAN
Massachusetts Other J24406 MEDICARE PTAN

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