Provider Demographics
NPI:1235443730
Name:BROFER, GREGG DONALD
Entity Type:Individual
Prefix:MR
First Name:GREGG
Middle Name:DONALD
Last Name:BROFER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PURCHASE ST
Mailing Address - Street 2:FOURTH FLOOR
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-6355
Mailing Address - Country:US
Mailing Address - Phone:508-990-0894
Mailing Address - Fax:
Practice Address - Street 1:800 PURCHASE ST
Practice Address - Street 2:FOURTH FLOOR
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6355
Practice Address - Country:US
Practice Address - Phone:508-990-0894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker