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JANE M BRODERICK
51 TERRYVILLE RD PORT JEFFERSON STATION NY 117761331

JANE M BRODERICK is physician registered in the Centers for Medicare & Medicaid Services (CMS). The National Provider Identifier (NPI) of the National Plan and Provider Enumeration System (NPPES) is 1598844342. The unique individual professional ID assigned by Provider Enrollment, Chain, and Ownership System (PECOS) is 4880617653. The primary specialty is CLINICAL SOCIAL WORKER. The organization is . The address is 51 TERRYVILLE RD, , PORT JEFFERSON STATION, NY, 117761331. The zip code is 117761331.


Nation Provider ID1598844342
PAC ID by PECOS4880617653
Professional Enrollment IDI20060106000537
NameJANE M BRODERICK
Medical School NameOTHER
Graduation Year1982
Primary SpecialtyCLINICAL SOCIAL WORKER
All secondary specialties
Organization Name
Group Practice PAC ID
Number of Group Practice members0
Address51 TERRYVILLE RD, , PORT JEFFERSON STATION, NY, 117761331
Hospital affiliation LBN
Graduation Year1982
Contact Number6314744100
Email Address[Show_Email_ID]

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