MEDICARE: MISS ASHLEY LYNN BROSKA AU.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	231H00000X	Audiologist	0023271	NY

General Provider Information

NPI Number	:	1821397274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ASHLEY LYNN BROSKA AU.D

Provider Business Mailing Address
First Line	:	1100 LONG POND RD
Second Line	:	SUITE 110
City	:	ROCHESTER
State	:	NY
Zip	:	14626-1154
Country	:	US
Telephone Number	:	585-225-1100
Fax Number	:	585-225-1112

Provider Business Practice Location Address
First Line	:	1100 LONG POND RD
Second Line	:	SUITE 110
City	:	ROCHESTER
State	:	NY
Zip	:	14626-1154
Country	:	US
Telephone Number	:	585-225-1100
Fax Number	:	585-225-1112

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

Provider Enumeration Date	:	03/24/2011
Last Update Date	:	06/05/2012

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