DR. DANIEL J BROUDER (NPI# 1659313963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659313963 |
| Entity Type | Individual |
| Full Name | DR. DANIEL J BROUDER |
| Credential | MD |
| Practice Address |
210 Jack Martin Blvd Suite D-1 Brick NJ 08724-7771 |
| Practice Telephone | 7324585067 |
| Practice Fax Number | 7324584962 |
| Mailing Telephone | 7324585067 |
| Mailing Fax Number | 7324584962 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2014-03-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
25MA07572700 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0052078 | 05 | |
| RAILROADMEDICARENUMBER | P00053546 | 01 |
| Street Address |
210 JACK MARTIN BLVD SUITE D-1 |
| City | BRICK |
| State | NJ |
| Zip Code | 08724-7771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942240429 | Winicjusz Palecki | Internal Medicine | 210 Jack Martin Blvd, Suite D-1, Brick, NJ 08724-7771 | 2006-06-07 |
| 1346640174 | Helen De La Cruz Olairez | Nurse Practitioner | 210 Jack Martin Blvd, Brick, NJ 08724-7771 | 2014-08-28 |
| 1972741957 | Ankit Prafulbhai Shah | Internal Medicine | 210 Jack Martin Blvd, Suite D 1, Brick, NJ 08724-7771 | 2009-01-28 |
| 1609804384 | Joseph V. Schirripa | Internal Medicine | 210 Jack Martin Blvd, Suite D-1, Brick, NJ 08724-7771 | 2006-06-29 |
| 1902842057 | Jin S. Park | Internal Medicine | 210 Jack Martin Blvd, Suite D-1, Brick, NJ 08724-7771 | 2006-06-20 |
| 1508801390 | Nadeem Z Haider | Internal Medicine | 210 Jack Martin Blvd, Suite D-1, Brick, NJ 08724-7771 | 2006-06-17 |
| 1801831854 | Stephen J. Ellis | Specialist | 210 Jack Martin Blvd, Suite D-1, Brick, NJ 08724-7771 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386498 | Mark Malak | Pharmacist | 668 New Jersey Ave # 70, Brick, NJ 08724 | 2020-11-08 |
| 1699381681 | Kimberly Granai | Nurse Practitioner | 1617 Nj-88, Brick Township, NJ 08724 | 2020-09-16 |
| 1407461346 | Marina N Samuel | Pharmacist | 1890 Rt 88, Brick, NJ 08724 | 2020-09-08 |
| 1255974440 | Diana Rachel Williamson | Pharmacy Technician | 1610 Rt. 88 West, Suite 103, Brick, NJ 08724 | 2019-10-21 |
| 1710536842 | Stephanie Ann Papa | Nurse Practitioner | 2125 Nj 88, Brick, NJ 08724 | 2019-09-11 |
| 1417504515 | Susan B Anthony | Physical Therapist | 676 Overlook Ct, Brick, NJ 08724 | 2019-08-22 |
| 1831688076 | Jennifer S Cashin | Social Worker | 1500 Nj-88, Brick, NJ 08724 | 2018-05-03 |
| 1528555315 | James Kish Pt | Physical Therapist | 602 Yellowbrick Rd, Brick, NJ 08724 | 2018-04-17 |
| 1396262200 | Michael Stephen Zito-govert | Nurse Practitioner | 1640 Route 88 West, Suite 203, Brick, NJ 08724 | 2017-08-23 |
| 1083140420 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Route 70 East, Brick, NJ 08724 | 2017-05-04 |
| Find all providers in zip 08724 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1952662140 | Eric Loman | Internal Medicine | 1617 Route 88 W Ste 101, Brick, NJ 08724-3010 | 2012-06-04 |
| 1013213206 | Mrugesh Chhaganlal Panchani | Internal Medicine | 210 Jack Martin Blvd Ste D1, Brick, NJ 08724-3063 | 2011-02-04 |
| 1376557546 | Keshani Jain | Internal Medicine | 1541 Rt 88 West, Suite A, Brick, NJ 08724 | 2006-07-27 |
| 1982618104 | Thomas J Tomasco | Internal Medicine | 524 Jessica Lane, Brick, NJ 08724 | 2006-07-27 |
| 1518991843 | Priya Anantharaman | Internal Medicine | 1541 Route 88 Ste A, Brick, NJ 08724-2373 | 2006-07-11 |
| 1467498402 | Jose I Iglesias | Internal Medicine | 210 Jack Martin Blvd., Suite D-1, Brick, NJ 08724 | 2006-06-20 |
| 1740220730 | Robert Bruno | Internal Medicine | 1541 Route 88, Suite A, Brick, NJ 08724-2373 | 2006-06-07 |
| 1942240429 | Winicjusz Palecki | Internal Medicine | 210 Jack Martin Blvd, Suite D-1, Brick, NJ 08724-7771 | 2006-06-07 |
| 1225006927 | Ira M Strauss | Internal Medicine | 150 Brick Blvd, Ste A, Brick, NJ 08723-4848 | 2006-03-09 |
| 1437591963 | Shore Renal Care | Internal Medicine | 1617 Route 88 W, Brick, NJ 08724-3010 | 2013-07-25 |
| Find all providers in BRICK | ||||
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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.