Provider Demographics
NPI:1164025961
Name:BRODSKY, BARRY (RPH)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:
Last Name:BRODSKY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ROCHE BROS WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1018
Mailing Address - Country:US
Mailing Address - Phone:508-230-0259
Mailing Address - Fax:
Practice Address - Street 1:62 QUARRYSTONE DR
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-1663
Practice Address - Country:US
Practice Address - Phone:508-269-6062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15460183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist