Provider Demographics
NPI:1336307529
Name:BRODER, ARKADY (MD)
Entity Type:Individual
Prefix:MR
First Name:ARKADY
Middle Name:
Last Name:BRODER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 RT 88W
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724
Mailing Address - Country:US
Mailing Address - Phone:732-458-8300
Mailing Address - Fax:732-458-8529
Practice Address - Street 1:1640 RT 88W
Practice Address - Street 2:SUITE 202
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724
Practice Address - Country:US
Practice Address - Phone:732-458-8300
Practice Address - Fax:732-458-8529
Is Sole Proprietor?:No
Enumeration Date:2008-05-25
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60255303207RG0100X
NJ25MA09209900207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology