DR. BETHANY A BRODERICK (NPI# 1407804834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407804834 |
| Entity Type | Individual |
| Full Name | DR. BETHANY A BRODERICK |
| Credential | MD |
| Practice Address |
1044 State St Schenectady NY 12307-1508 |
| Practice Telephone | 5183701441 |
| Practice Fax Number | 5183959431 |
| Mailing Telephone | 5183701441 |
| Mailing Fax Number | 5183959431 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2009-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 239752 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02995513 | 05 | |
| NY | 02756527 | 05 |
| Street Address |
1044 STATE ST |
| City | SCHENECTADY |
| State | NY |
| Zip Code | 12307-1508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497751010 | Edwin Robert Windle | Internal Medicine | 1044 State St, Schenectady, NY 12307-1508 | 2005-06-28 |
| 1508492901 | Prajna Yerusu | Dentist | 1044 State St, Schenectady, NY 12307-1508 | 2020-03-17 |
| 1770114803 | Erin E Bellinger-horton | Dental Hygienist | 1044 State St, Schenectady, NY 12307-1508 | 2020-01-28 |
| 1538705819 | Schenectady Family Health Services, Inc. | Clinic/Center | 1044 State St, Schenectady, NY 12307-1508 | 2019-11-21 |
| 1467010033 | Linda Xuan West | Nurse Practitioner | 1044 State St, Schenectady, NY 12307-1508 | 2019-05-30 |
| 1942866280 | Tadele Demisse | Student in an Organized Health Care Education/Training Program | 1044 State St, Schenectady, NY 12307-1508 | 2019-05-13 |
| 1417412230 | See Seo | Pharmacist | 1044 State St, Schenectady, NY 12307-1508 | 2019-02-06 |
| 1053894717 | Elizabeth Anne Weissbart | Nurse Practitioner | 1044 State St, Schenectady, NY 12307-1508 | 2018-09-10 |
| 1003398033 | Miranda A Savignano | Dental Hygienist | 1044 State St, Schenectady, NY 12307 | 2018-09-06 |
| 1578049334 | Terry J Kallner Jr. | Nurse Practitioner | 1044 State St, Schenectady, NY 12307-1508 | 2018-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417464322 | Emily Marsh | Social Worker | 738 State St, Schenectady, NY 12307 | 2018-01-02 |
| 1982820213 | Mohawk Opportunities, Inc. | Community Based Residential Treatment Facility, Mental Illness | 201 Nott Terrace, Schenectady, NY 12307 | 2007-04-17 |
| 1194819854 | Carver Community Center of Schenectady, Inc. | Counselor | 846 State Street, Schenectady, NY 12307 | 2006-10-03 |
| 1366764755 | David A Geloso | Pharmacist | 1044 State Street, Schenectady, NY 12307-0000 | 2010-02-25 |
| 1881071819 | Bethesda House of Schenectady, Inc. | Psychologist | 834 State St, Schenectady, NY 12307-1202 | 2015-04-28 |
| 1326106956 | Thomas John Kuettel | Family Medicine | 846 State St, Schenectady, NY 12307-1202 | 2006-12-05 |
| 1265929210 | Kelly Noble | Registered Nurse | 738 State St, Schenectady, NY 12307-1206 | 2018-04-16 |
| 1518465251 | Tricia Brownell | Rehabilitation Counselor | 738 State St, Schenectady, NY 12307-1206 | 2018-01-29 |
| 1144728932 | Amy Michelle Della Rocco | Rehabilitation Counselor | 738 State St, Schenectady, NY 12307-1206 | 2018-01-26 |
| 1265412621 | Schenectady Ambulance Service, Inc. | Ambulance | 793 State St, Schenectady, NY 12307-1209 | 2006-01-20 |
| Find all providers in zip 12307 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487937348 | Community Care Physicians, PC | Pediatrics | 3732 Carman Rd., Schenectady, NY 12303-5422 | 2011-09-27 |
| 1891860102 | Dai Mook Lim | Pediatrics | 1370 Union Street, Schenectady, NY 12308-3017 | 2006-11-21 |
| 1811925019 | Bradley Alan Ford | Pediatrics | 3732 Carman Rd, Schenectady, NY 12303-5422 | 2006-06-28 |
| 1588624829 | Nam Soo Lee | Pediatrics | 1726 Campbell Ave, Schenectady, NY 12306 | 2006-03-23 |
| 1063496768 | Hadi Koohsari | Pediatrics | 701 Union St, Schenectady, NY 12305-1504 | 2005-12-06 |
| 1528420700 | Samantha Ann Barden | Pediatrics | 3732 Carman Rd, Schenectady, NY 12303-5422 | 2016-03-25 |
| 1548543812 | Community Care Physicians, PC | Pediatrics | 700 Mcclellan Street, Schenectady, NY 12304-1019 | 2011-09-23 |
| 1518193606 | Fayanne Maria Fraser | Pediatrics | 1044 State St, Schenectady, NY 12307-1508 | 2009-06-03 |
| 1306959812 | Richard Yan | Pediatrics | 700 Mcclellan St, Schenectady, NY 12304-1019 | 2006-08-17 |
| 1255349916 | Margaret M Woods | Pediatrics | 700 Mcclellan St, Schenectady, NY 12304-1019 | 2006-08-04 |
| Find all providers in SCHENECTADY | ||||
| City | SCHENECTADY |
| Zip Code | 12307 |
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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.