MEDICARE: MARTIN B. BRODSKY PH.D., SC.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP.15111	OH
2	235Z00000X	Speech-Language Pathologist	05850	MD

General Provider Information

NPI Number	:	1144471228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN B. BRODSKY PH.D., SC.M.

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE # A71
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	216-445-6468
Fax Number	:	216-445-9409

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0005
Country	:	US
Telephone Number	:	216-445-6468
Fax Number	:	216-445-9409

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2008
Last Update Date	:	09/06/2022

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Directions to “ MARTIN B. BRODSKY PH.D., SC.M.” Practice Location

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