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NPI Code Detail

MEDICARE: BETSY BROMBERG MS/CCC-A

MEDICARE: BETSY BROMBERG MS/CCC-A
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
1231H00000XAudiologist001059NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255327821
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETSY BROMBERG MS/CCC-A
Provider Business Mailing Address
First Line : 222 E 41ST ST FL 8
Second Line :
City : NEW YORK
State : NY
Zip : 10017-6739
Country : US
Telephone Number : 212-263-7567
Fax Number :
Provider Business Practice Location Address
First Line : 222 E 41ST ST FL 8
Second Line :
City : NEW YORK
State : NY
Zip : 10017-6739
Country : US
Telephone Number : 212-263-7567
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 03/01/2021

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Directions to “ BETSY BROMBERG MS/CCC-A” Practice Location

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