Healthcare Provider Details

I. General information

NPI: 1871222901
Provider Name (Legal Business Name): BRODERICK HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2022
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 MAIN ST
NORTH READING MA
01864-2280
US

IV. Provider business mailing address

135 MAIN ST
NORTH READING MA
01864-2280
US

V. Phone/Fax

Practice location:
  • Phone: 617-905-1978
  • Fax:
Mailing address:
  • Phone: 617-905-1978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN BRODERICK
Title or Position: FNP
Credential:
Phone: 617-905-1978