James Edward Broderick
Foot Surgery
470 S Pearl St
Canandaigua
, New York 14424
James Edward Broderick
Foot Surgery
470 S Pearl St
Canandaigua
, New York 14424
(585) 394-8563
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About
Features
Specialties
- Foot Surgery
Languages spoken
- English
Location
First Address
- James Edward Broderick
- 470 S Pearl St
- Canandaigua, NY
- Zip : 14424
- Fax : (585) 394-8563
- Phone : (585) 394-4070
Second Address
- James Edward Broderick
- 470 S Pearl St
- Canandaigua, NY
- Zip : 14424
- Fax : (585) 394-8563
- Phone : (585) 394-4070
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0131X | Foot Surgery | N004540 | NY |
National Provider Identifier
| NPI | 1093726473 |
|---|---|
| Provider Name | James Edward Broderick |
| First Address | Canandaigua, NY 14424 |
| Second Address | Canandaigua, NY 14424 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/08/2006 |
| Last Update Date | 22/11/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 01158323 | (05) | NY |
| 480007845 | RR MEDICARE (01) | NY |
| 8110 | ROCHESTER BL SHIELD (01) | NY |
| T92375 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.