Provider Demographics
NPI:1659809101
Name:BROOMELL, EMILY R (DO)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:R
Last Name:BROOMELL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 HIGHLANDS DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-7507
Mailing Address - Country:US
Mailing Address - Phone:717-393-1338
Mailing Address - Fax:717-627-1817
Practice Address - Street 1:1575 HIGHLANDS DR STE 101
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-7507
Practice Address - Country:US
Practice Address - Phone:717-393-1338
Practice Address - Fax:717-627-1817
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS021509207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology