Brodsky, Ivan Louis

Brodsky, Ivan Louis is an individual health care provider with primary practice located at 4225 Golden Valley Rd , Golden Valley MN 55422-4215. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Brodsky, Ivan Louis can be contacted via phone (763) 588-0661.

Contact Information

Primary practice address
4225 Golden Valley Rd Golden Valley MN 55422-4215
Phone: (763) 588-0661
Fax: (763) 302-4345
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 18799 Minnesota

Profile Details

NPI number 1710932009
LBN Legal business name Brodsky, Ivan Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Mar 5th, 2019 - about 7 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 1710932009 NPPES
Minnesota Other 0265003 PREFERRED ONE
Minnesota Other 0500353 PREFERRED ONE
Minnesota MEDICAID 183070800 PREFERRED ONE
Minnesota MEDICAID 30204400 PREFERRED ONE
Minnesota Other 02062BR PREFERRED ONE
Minnesota Other 22782 PREFERRED ONE
Minnesota MEDICAID 0507376 PREFERRED ONE
Minnesota Other HP12967 PREFERRED ONE
Minnesota Other 100279C029 PREFERRED ONE
Minnesota Other 130004298 PREFERRED ONE

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