MEDICARE: WENDY J BRODSKY D.C.

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	111N00000X	Chiropractor	X003347-1	NY

General Provider Information

NPI Number	:	1508838103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY J BRODSKY D.C.

Provider Business Mailing Address
First Line	:	46 PEBBLE LN
Second Line	:
City	:	ROSLYN HTS
State	:	NY
Zip	:	11577-2712
Country	:	US
Telephone Number	:	516-484-5058
Fax Number	:

Provider Business Practice Location Address
First Line	:	46 PEBBLE LN
Second Line	:
City	:	ROSLYN HTS
State	:	NY
Zip	:	11577-2712
Country	:	US
Telephone Number	:	516-484-5058
Fax Number	:

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	10/23/2007

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