Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 135037 | NY |
N | 2080P0207X | Pediatric Hematology-Oncologist | MA39965 | NJ |
NPI | 1073552220 |
---|---|
Provider Name | Dr. Joel Aaron Brochstein |
First Address | Chappaqua, NY 10514-1419 |
Second Address | New Hyde Park, NY 11040-1433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 24/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B80578 | (02) | NJ |