JAMES EDWARD BRODERICK (NPI# 1093726473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093726473 |
| Entity Type | Individual |
| Full Name | JAMES EDWARD BRODERICK |
| Credential | DPM |
| Practice Address |
470 S Pearl St Canandaigua NY 14424 |
| Practice Telephone | 5853944070 |
| Practice Fax Number | 5853948563 |
| Mailing Telephone | 5853944070 |
| Mailing Fax Number | 5853948563 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2016-11-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
N004540 | NY | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | RR MEDICARE | 480007845 | 01 |
| NY | ROCHESTER BL SHIELD | 8110 | 01 |
| NY | 01158323 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073663183 | James L. Broderick | Psychologist | 735 State St Ste 203, Santa Barbara, CA 93101-5502 | 2007-01-11 |
| 1528568086 | James E Broderick Jr. | Behavior Technician | 205 Burlington Rd, Bedford, MA 01730-1406 | 2018-02-20 |
| Street Address |
470 S PEARL ST |
| City | CANANDAIGUA |
| State | NY |
| Zip Code | 14424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497074249 | James E. Broderick | Podiatrist | 470 S Pearl St, Canandaigua, NY 14424-1702 | 2010-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730725029 | Stefanie Ann Hook | Nurse Practitioner | 395 West Street, Suite 101, Canandaigua, NY 14424 | 2019-11-21 |
| 1285120618 | Mary Kathleen Woodruff | Counselor | 163 Gibson Street, Canandaigua, NY 14424 | 2018-07-09 |
| 1699260612 | Victoria Record | Nurse Practitioner | 3325 Marvin Sands Dr, Canandaigua, NY 14424 | 2018-06-22 |
| 1649767443 | Liana Irene Schenk | Counselor | 5297 Parkside Drive, Building 400, Suite 408, Canandaigua, NY 14424 | 2018-04-17 |
| 1225534019 | Brook Slaby | Counselor | 5297 Parkside Dr Building 400 Office 411, Canandaigua, NY 14424 | 2018-04-02 |
| 1154839710 | Madasyn Leigh Smith | Physical Therapist | 229 Parrish St Ste 220, Canandaigua, NY 14424 | 2018-01-17 |
| 1295259992 | Melissa Ann Frarey | Licensed Practical Nurse | 4998 Wyffels Road, Canandaigua, NY 14424 | 2017-08-03 |
| 1235674599 | Wendy Williams | Early Intervention Provider Agency | 5145 North Bloomfiled Road, Canandaigua, NY 14424 | 2016-12-22 |
| 1326418252 | Mary Christine Casella | Registered Nurse | 90 West Gibson Street, Canandaigua, NY 14424 | 2015-10-05 |
| 1417351453 | Holly Jean Jackson | Licensed Practical Nurse | 5a Lafayette Avenue, Canandaigua, NY 14424 | 2014-10-20 |
| Find all providers in zip 14424 | ||||
| Taxonomy Code | 213ES0131X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497074249 | James E. Broderick | Podiatrist | 470 S Pearl St, Canandaigua, NY 14424-1702 | 2010-05-19 |
| 1851561948 | Marcie Marie Struck | Podiatrist | 400 Fort Hill Ave, Canandaigua, NY 14424-1159 | 2008-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376159756 | West Side Foot Group, L.l.p. | Podiatrist | 244 W 54th St Fl 10, New York, NY 10019-5597 | 2020-09-21 |
| 1740815836 | Ernest L Isaacson Dpm PC | Podiatrist | 4 Technology Dr Ste 110, East Setauket, NY 11733-4068 | 2020-03-09 |
| 1619502242 | Westhampton Beach Podiatry P.C. | Podiatrist | 70 C Old Riverhead Road, Westhampton Beach, NY 11978 | 2020-03-04 |
| 1568025641 | Afsana Qader, Dpm P.c | Podiatrist | 182 Martine Ave, White Plains, NY 10601-3305 | 2019-04-15 |
| 1396233664 | Dr. Mariola Rivera Podiatry, Pllc | Podiatrist | 10 Mitchell Pl Ste 105, White Plains, NY 10601-4300 | 2018-04-23 |
| 1457856403 | Bgy Podiatry PC | Podiatrist | 9810 64th Ave Apt Gb, Rego Park, NY 11374-2501 | 2018-03-29 |
| 1184135568 | Active Podiatry Pllc | Podiatrist | 149 Marine Ave Apt La, Brooklyn, NY 11209-7712 | 2017-10-12 |
| 1730623869 | Westside Podiatry Group | Podiatrist | 507 Beahan Rd, Rochester, NY 14624-3403 | 2016-12-08 |
| 1386191203 | Comprehensive Podiatric Foot Care Pllc | Podiatrist | 88-34 161th Street, Jamaica, NY 11432-4040 | 2016-09-08 |
| 1104277185 | Zhi Q Huang | Podiatrist | 2130 E 24th St, First Floor, Brooklyn, NY 11229-4902 | 2016-06-30 |
| Find all providers with the same taxonomy | ||||
| City | CANANDAIGUA |
| Zip Code | 14424 |
Please comment or provide details below to improve the information on JAMES EDWARD BRODERICK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.