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NPI Code Detail

MEDICARE: GOLDIE VIRGINIA BROTOSKY

MEDICARE: GOLDIE VIRGINIA BROTOSKY
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
1376J00000XHomemaker

General Provider Information

NPI Number : 1699379586
Entity Type Code : Individual
Provider Name (Legal Business Name) : GOLDIE VIRGINIA BROTOSKY
Provider Business Mailing Address
First Line : 172 CASTO LN
Second Line :
City : BUFFALO
State : WV
Zip : 25033-7509
Country : US
Telephone Number : 304-610-8920
Fax Number : 304-471-2488
Provider Business Practice Location Address
First Line : 4510 PENNSYLVANIA AVE
Second Line :
City : CHARLESTON
State : WV
Zip : 25302-4835
Country : US
Telephone Number : 304-965-9081
Fax Number : 304-346-1860
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2020
Last Update Date : 11/25/2020

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Directions to “ GOLDIE VIRGINIA BROTOSKY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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