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General NPI Number Information
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NPI Number | 1093024887
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Entity Type | Individual
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Provider Name | AMBER MICHELLE BRODY D.O.
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Gender | Female
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 1890 PALMER AVENUE STE 304
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City | LARCHMONT
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State | NY
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Zip | 10538-3031
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Country | US
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Telephone | 914-834-9606
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Fax | 914-834-0648
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Provider Business Mailing Address
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Address Line | 1890 PALMER AVENUE STE 304
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City | LARCHMONT
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State | NY
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Zip | 10538-3031
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Country | US
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Telephone | 914-834-9606
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Fax | 914-834-0648
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 258796
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 258796
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 258796
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 61935
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License Number State | CT
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