Provider Demographics
NPI:1508838103
Name:BRODSKY, WENDY J (DC)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:J
Last Name:BRODSKY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 PEBBLE LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2712
Mailing Address - Country:US
Mailing Address - Phone:516-484-5058
Mailing Address - Fax:
Practice Address - Street 1:46 PEBBLE LN
Practice Address - Street 2:
Practice Address - City:ROSLYN HTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2712
Practice Address - Country:US
Practice Address - Phone:516-484-5058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003347-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor