Provider Demographics
NPI:1922142876
Name:BRODSKY FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:BRODSKY FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRODSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:718-563-0384
Mailing Address - Street 1:27 N CENTRAL AVE
Mailing Address - Street 2:APT
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-2425
Mailing Address - Country:US
Mailing Address - Phone:718-563-0384
Mailing Address - Fax:718-563-0338
Practice Address - Street 1:108 E 183RD ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-1237
Practice Address - Country:US
Practice Address - Phone:718-563-0384
Practice Address - Fax:718-563-0338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
X2B021Medicare ID - Type Unspecified