Provider Demographics
NPI:1770582082
Name:BRODSKY, JASON AARON (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:AARON
Last Name:BRODSKY
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:9715 MEDICAL CENTER DR
Mailing Address - Street 2:#233
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3320
Mailing Address - Country:US
Mailing Address - Phone:240-403-0621
Mailing Address - Fax:240-306-0770
Practice Address - Street 1:9715 MEDICAL CENTER DR
Practice Address - Street 2:#233
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3320
Practice Address - Country:US
Practice Address - Phone:240-403-0621
Practice Address - Fax:240-306-0770
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2023-04-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD63623208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H61896Medicare UPIN