MITCHELL V BRODEY (NPI# 1174501498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174501498 |
| Entity Type | Individual |
| Full Name | MITCHELL V BRODEY |
| Credential | MD |
| Practice Address |
4900 Broad Rd Pob Ste 4k Syracuse NY 13215-2265 |
| Mailing Address |
1001 W Fayette St Ste 400 Syracuse NY 13204-2859 |
| Practice Telephone | 3154925784 |
| Practice Fax Number | 3154925183 |
| Mailing Telephone | 3154721488 |
| Mailing Fax Number | 3154728060 |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2008-05-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
141878 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
4900 BROAD RD POB STE 4K |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13215-2265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336143221 | David C Canfield | Anesthesiology | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2005-06-08 |
| 1205474335 | Meaghan Porter | Physical Therapist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-12-19 |
| 1982262655 | Ryan Christopher Staib | Nurse Anesthetist, Certified Registered | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-05-29 |
| 1164989505 | Jessica Detor | Social Worker | 4900 Broad Rd, Physician Office Building North 3n, Syracuse, NY 13215-2265 | 2019-02-21 |
| 1316402415 | Oleksandr Kaplun | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2019-02-04 |
| 1003390204 | Ianna Javier Garcia | Occupational Therapist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2018-09-24 |
| 1194207241 | Rebekah Schu | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2018-09-05 |
| 1669990065 | Katrina E Garrigan | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-09-06 |
| 1336667948 | Kristy Mcgough | Physician Assistant | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-09-04 |
| 1285158402 | Nicholas David Treinin | Pharmacist | 4900 Broad Rd, Syracuse, NY 13215-2265 | 2017-07-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396367785 | Jeffrey Alan Gaulrapp | Registered Nurse | Upstate University Hospital Community General Campus, 4900 Broad Road, Syracuse, NY 13215 | 2020-05-08 |
| 1134752454 | Crystal Elizabeth Hoban | Marriage & Family Therapist | 4922 W. Seneca Turnpike, Syracuse, NY 13215 | 2020-02-14 |
| 1083004907 | Roger G Levine Md | Psychiatric Residential Treatment Facility | 4914 West Seneca Turnpkie, Syracuse, NY 13215 | 2015-01-30 |
| 1558771071 | Edleanna Robinson | Licensed Practical Nurse | 5075 W Seneca Turnpike, Syracuse, NY 13215 | 2014-05-06 |
| 1689013450 | Rhonda Lee Philopena | Emergency Medicine | 4900 Broad Rd 1st Fl, Syracuse, NY 13215 | 2013-06-14 |
| 1962778498 | Marie Anne Stevens | Licensed Practical Nurse | 4057 Seneca Tpk, Van Duyn Home and Hospital, Syracuse, NY 13215 | 2012-03-29 |
| 1033439088 | Anna-marie Simpson | Chiropractor | 4922 W Seneca Tpke, Syracuse, NY 13215 | 2010-06-01 |
| 1992028690 | A John Wylie | Pharmacist | 4840 Sherwood Dr., Syracuse, NY 13215 | 2010-03-09 |
| 1669616512 | Asalim A Thabet | Emergency Medicine | 4900 Braod Rd, 1st Fl, Syracuse, NY 13215 | 2009-04-22 |
| 1992948707 | Jesse Reed Gutnick | Surgery | 4900 Borad Rd, Suite 23 North, Syracuse, NY 13215 | 2009-04-08 |
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| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205952280 | Kristopher Mark Paolino | Internal Medicine | 725 Irving Ave Ste 311, Syracuse, NY 13210-1685 | 2007-03-22 |
| 1891027512 | Mark Edward Polhemus | Internal Medicine | 725 Irving Ave, Suite 311, Syracuse, NY 13210-1603 | 2010-02-05 |
| 1235391947 | Waleed Javaid | Internal Medicine | 725 Irving Ave, Suite 311, Syracuse, NY 13210-1603 | 2008-06-25 |
| 1437317658 | Elizabeth A. Asiago-reddy | Internal Medicine | 725 Irving Ave, Suite 314, Syracuse, NY 13210-1603 | 2008-05-23 |
| 1114086618 | David P Paar | Internal Medicine | 725 Irving Ave, Ste 311, Syracuse, NY 13210-1603 | 2006-12-08 |
| 1538194832 | Sally P Klemens | Internal Medicine | 301 Prospect Ave, Infectious Disease Consultants, Syracuse, NY 13203-1807 | 2006-07-12 |
| 1487683736 | Donald C Blair | Internal Medicine | 725 Irving Ave, Suite 311, Syracuse, NY 13210-1603 | 2006-06-30 |
| 1356379697 | Frederick B Rose | Internal Medicine | 750 E Adams St, Syracuse, NY 13210-2306 | 2006-06-28 |
| 1326074865 | Timothy P Endy | Internal Medicine | 725 Irving Ave, Suite 311, Syracuse, NY 13210-1603 | 2006-06-25 |
| 1427092493 | Michael Henry Cynamon | Internal Medicine | 800 Irving Ave, Syracuse, NY 13210-2716 | 2006-06-16 |
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| 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.