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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 ID||1598844342|
|PAC ID by PECOS||4880617653|
|Professional Enrollment ID||I20060106000537|
|Name||JANE M BRODERICK|
|Medical School Name||OTHER|
|Primary Specialty||CLINICAL SOCIAL WORKER|
|All secondary specialties|
|Group Practice PAC ID|
|Number of Group Practice members||0|
|Address||51 TERRYVILLE RD, , PORT JEFFERSON STATION, NY, 117761331|
|Hospital affiliation LBN|