Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 046965 | CT |
NPI | 1295769685 |
---|---|
Provider Name | Marc Eric Brodsky |
First Address | Stamford, CT 06901 |
Second Address | Stamford, CT 06901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 20/06/2011 |