MEDICARE: DR. VERONICA J. BRODSKY PSY. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	016790	NY

General Provider Information

NPI Number	:	1386717197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VERONICA J. BRODSKY PSY. D.

Provider Business Mailing Address
First Line	:	65 ORIENTAL BLVD APT 12D
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-4913
Country	:	US
Telephone Number	:	718-306-7755
Fax Number	:

Provider Business Practice Location Address
First Line	:	6415 BAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3947
Country	:	US
Telephone Number	:	718-331-3800
Fax Number	:	718-331-3387

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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