Provider Demographics
NPI:1932459872
Name:BROSZKO, MAGDALENA JUSTYNA (MD)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:JUSTYNA
Last Name:BROSZKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-922-3144
Mailing Address - Fax:585-922-1399
Practice Address - Street 1:224 ALEXANDER ST STE 4000
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-4000
Practice Address - Country:US
Practice Address - Phone:585-922-7770
Practice Address - Fax:585-922-7246
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2884682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry