Christina Rose Broderick, MSED
Specialist in Bethpage, NY. Individual provider (NPI-1).
NPI number1619215423
StatusActive
Last updated in NPPESJan 29, 2013
Details
- NPI
- 1619215423
- Entity type
- Individual (NPI-1)
- Name
- Ms. Christina Rose Broderick
- Credential
- MSED
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 29, 2013
- Last updated
- Jan 29, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | NY | Yes |
Practice location
162 BroadwayBethpage, NY 11714-4417
Phone 516-547-3658
Mailing address
162 BroadwayBethpage, NY 11714-4417
Phone 516-547-3658
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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