Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 36398 | TN |
NPI | 1184627382 |
---|---|
Provider Name | Dr. Alberto Broniscer |
First Address | Memphis, TN 38105-3678 |
Second Address | Memphis, TN 38105-3678 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 05/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00126518 | (05) | MS |
0030341 | (05) | NJ |
0071961 | (05) | MT |
009905345 | (05) | AL |
100847840A | (05) | OK |
104677849 | (05) | MI |
1136395 | (05) | LA |
186358377A | (05) | GA |
200336060A | (05) | KS |
200400610A | (05) | IN |
205951007 | (05) | MO |
2524085 | (05) | OH |
3496709 | (05) | TN |
360488800 | (05) | MN |
422400000 | (05) | ME |
563072 | (05) | IA |
64056849 | (05) | KY |
804030 | (05) | AZ |
H62912 | (02) | TN |