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General NPI Number Information
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NPI Number | 1750519757
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Entity Type | Individual
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Provider Name | MARNI ILANA KAPLAN BRODER DPM
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Gender | Female
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 27 CELLER RD
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City | EDISON
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State | NJ
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Zip | 08817-2971
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Country | US
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Telephone | 201-674-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 27 CELLER RD
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City | EDISON
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State | NJ
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Zip | 08817-2971
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Country | US
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Telephone | 201-674-8000
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Fax |
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00297900
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License Number State | NJ
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