Provider Demographics
NPI:1043399702
Name:BRODKIN WHITE, JOANNE TORTOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:TORTOMAS
Last Name:BRODKIN WHITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOANNE
Other - Middle Name:TORTOMAS
Other - Last Name:BRODKIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:45 ASHLEY AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-1912
Mailing Address - Country:US
Mailing Address - Phone:845-326-8074
Mailing Address - Fax:
Practice Address - Street 1:45 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-1912
Practice Address - Country:US
Practice Address - Phone:845-326-8074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2257382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry