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General NPI Number Information
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NPI Number | 1568474542
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Entity Type | Individual
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Provider Name | MILTON BARNEY BRODKOWITZ MS-AUDIOLOGIST
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Gender | Male
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 08/10/2009
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Provider Practice Location Address
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Address Line | 3 PENN PLZ E
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City | NEWARK
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State | NJ
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Zip | 07105-2258
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Country | US
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Telephone | 973-522-1292
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Fax | 973-522-1294
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Provider Business Mailing Address
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Address Line | PO BOX 406153
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City | ATLANTA
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State | GA
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Zip | 30384-1876
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Country | US
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Telephone | 561-478-8770
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Fax | 561-598-7231
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 41YA00020200
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License Number State | NJ
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