Provider Demographics
NPI:1841550779
Name:BRODSKY, BRITTANY (RD)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BRODSKY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4035 GABLES LANE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350
Mailing Address - Country:US
Mailing Address - Phone:630-453-9960
Mailing Address - Fax:
Practice Address - Street 1:4035 GABLES LN
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-5028
Practice Address - Country:US
Practice Address - Phone:630-453-9960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003828133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered