DR. ROGER L. BROTMAN (NPI# 1013910074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013910074 |
| Entity Type | Individual |
| Full Name | DR. ROGER L. BROTMAN |
| Credential | M.D. |
| Practice Address |
825 N Main St Providence RI 02904-5707 |
| Practice Telephone | 4015219700 |
| Practice Fax Number | 4017511686 |
| Mailing Telephone | 4015219700 |
| Mailing Fax Number | 4017511686 |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 05415 | RI | Other Service Providers |
| Street Address |
825 N MAIN ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02904-5707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538162508 | Scott A. Triedman | Radiology | 825 N Main St, Providence, RI 02904-5707 | 2005-05-24 |
| 1689030579 | Sheva Mirdamadi- Tehrani | Nurse Practitioner | 825 N Main St, Providence, RI 02904 | 2016-01-07 |
| 1295861292 | Margaret S. Wool | Social Worker | 825 N Main St, Providence, RI 02904-5767 | 2007-02-26 |
| 1285637256 | Gabriela B Masko | Radiology | 825 N Main St, Providence, RI 02904-5707 | 2005-05-24 |
| 1912900879 | Kathy Radie Keane | Radiology | 825 N Main St, Providence, RI 02904-5707 | 2005-05-24 |
| 1871596833 | Donald R. Joyce | Radiology | 825 N Main St, Providence, RI 02904-5707 | 2005-05-24 |
| 1801899760 | Nicklas B Oldenburg | Radiology | 825 N Main St, Providence, RI 02904-5707 | 2005-05-24 |
| 1376546267 | Radiation Oncology Associates Inc | Radiology | 825 N Main St, Providence, RI 02904-5707 | 2005-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144792383 | Lifespan Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 180 Corliss Street, Suite A, Providence, RI 02904 | 2018-12-28 |
| 1780168229 | Beth M. Kalunian | Social Worker | 480 Charles Street, Providence, RI 02904 | 2018-09-20 |
| 1588161608 | Michael P. Johnson, Md, Inc | Internal Medicine | 148 W River St Ste 22b, Providence, RI 02904 | 2018-04-06 |
| 1780045948 | Fred Saccoccio | Pharmacist | 15 Smithfield Road, No Providence, RI 02904 | 2016-03-16 |
| 1699148999 | Latin Adult Day Health Care Center | Clinic/Center | 665 Charles Street, Providence, RI 02904 | 2015-11-09 |
| 1144639956 | Dina P Toolin | Occupational Therapist | 195 Collyer St. 3rd Floor, University Medical Center/miriam Hospital Outpatient, Providence, RI 02904 | 2014-08-06 |
| 1801208798 | Seth Clark | Internal Medicine | 200 Corliss St, Providence, RI 02904 | 2014-05-27 |
| 1134554645 | Molly Elizabeth Smith | Physical Therapist | 1405 Douglas Ave, North Providence, RI 02904 | 2013-09-04 |
| 1336408723 | Emad Awa | Pediatrics | 1 Randall Sq Ste 404, Providence, RI 02904 | 2012-05-07 |
| 1598036790 | Joseph F. Osmanski, Od, Inc | Optometrist | 1971 Mineral Spring Avenue, N. Providence, RI 02904 | 2012-01-19 |
| Find all providers in zip 02904 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164847380 | Cheryl Mandel | Specialist | 127 Irving Ave Apt 3, Providence, RI 02906-4544 | 2014-02-25 |
| 1962719773 | Megan Elizabeth Gillard | Specialist | 1000 Eddy Sttreet, Providence, RI 02905 | 2010-09-01 |
| 1053642611 | Robert Patrick Bowe | Specialist | 420 Angell St, Providence, RI 02906-4444 | 2010-01-21 |
| 1972832814 | Deborah A. Newell | Specialist | 10000 Eddy Street, Providence, RI 02905 | 2009-12-23 |
| 1669529004 | Jack Morton Monchik | Specialist | 154 Waterman Street, Providence, RI 02906-5713 | 2007-01-05 |
| 1588679385 | Lifespan/physicians Pso Billing Services | Specialist | 167 Point St, Coro 3a, Providence, RI 02903-4771 | 2006-07-30 |
| 1821020231 | Fernanda Goncalves | Specialist | 1000 Eddy Str., Providence, RI 02905 | 2006-07-07 |
| 1437123403 | Rebecca Mary Brown | Specialist | 700 Smith St, Providence, RI 02908 | 2006-02-15 |
| 1861486664 | Martin R Papazian | Specialist | 148 W River St, Suite 2a, Providence, RI 02904-2615 | 2005-09-07 |
| 1558364604 | Marc S Weinberg | Specialist | 1 Randall Sq Ste 304, Providence, RI 02904-2773 | 2005-05-23 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02904 |
Please comment or provide details below to improve the information on DR. ROGER L. BROTMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.