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General NPI Number Information
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NPI Number | 1184771024
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Entity Type | Organization
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Legal Business Name | BROOME NEUROSCIENCES, P C
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 10/04/2010
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Provider Practice Location Address
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Address Line | 38 FRONT ST
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City | BINGHAMTON
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State | NY
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Zip | 13905-4712
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Country | US
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Telephone | 607-772-9556
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Fax |
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Provider Business Mailing Address
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Address Line | 38 FRONT ST
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City | BINGHAMTON
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State | NY
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Zip | 13905-4712
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Country | US
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Telephone | 607-772-9556
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SOWBHAGYA L SONTHINENI
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Credential | MD
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Telephone | 607-772-9556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 137010
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 135864
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License Number State | NY
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