MEDICARE: EMILYN BRODSKY

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1811733207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILYN BRODSKY

Provider Business Mailing Address
First Line	:	3 HUNTINGTON QUADRANGLE STE 103N
Second Line	:
City	:	MELVILLE
State	:	NY
Zip	:	11747-4601
Country	:	US
Telephone Number	:	516-474-2816
Fax Number	:

Provider Business Practice Location Address
First Line	:	8040 COOPER AVE BLDG 4
Second Line	:
City	:	GLENDALE
State	:	NY
Zip	:	11385-7725
Country	:	US
Telephone Number	:	718-725-7970
Fax Number	:

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

Provider Enumeration Date	:	07/03/2024
Last Update Date	:	07/03/2024

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Directions to “ EMILYN BRODSKY ” Practice Location

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