Healthcare Provider Details

I. General information

NPI: 1376523829
Provider Name (Legal Business Name): CHERYL BRODSKY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 ELMWOOD AVE
PROVIDENCE RI
02907-2423
US

IV. Provider business mailing address

35 LORIMER AVE
PROVIDENCE RI
02906-3604
US

V. Phone/Fax

Practice location:
  • Phone: 401-300-5757
  • Fax: 401-300-5656
Mailing address:
  • Phone: 401-331-6980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number08584
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: