SCOTT BRODERICK (NPI# 1083957575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083957575 |
| Entity Type | Individual |
| Full Name | SCOTT BRODERICK |
| Credential | RN |
| Practice Address |
118 Algonquin Pk Plattsburgh NY 12901 |
| Mailing Address |
118 Algonquin Park Plattsburgh NY 12901-1193 |
| Practice Telephone | 5185728780 |
| Mailing Telephone | 5185728780 |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2013-04-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
118 ALGONQUIN PK |
| City | PLATTSBURGH |
| State | NY |
| Zip Code | 12901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093284721 | Get Movin Inc | Non-emergency Medical Transport (VAN) | 316 Cornelia St, 21a, Plattsburgh, NY 12901 | 2018-11-26 |
| 1528536141 | Inmaculada Ibanez-casas | Technician | Sibley Hall, 113 Rugar Street, Plattsburgh, NY 12901 | 2018-11-13 |
| 1760950372 | Martha R Wasserbauer | Dietetic Technician, Registered | Mountain View Pediatrics, 18 Feathers Drive, Plattsburgh, NY 12901 | 2018-11-13 |
| 1568958411 | Joel Cherian | Student in an Organized Health Care Education/Training Program | 159 Margaret St Ste 100, Plattsburgh, NY 12901 | 2018-07-03 |
| 1396284477 | Florence Reynaud | Acupuncturist | 135 S. Peru Street, Adirondack Integrative Wellness Center, Plattsburgh, NY 12901 | 2017-02-22 |
| 1124565783 | Mytchel Hector | Registered Nurse | 43 Hamilton Street Apt #202, Plattsburgh, NY 12901 | 2017-01-20 |
| 1780136697 | Michael Bruso | Psychologist | 5436 Peru St. Apt. 5, Plattsburgh, NY 12901 | 2016-10-26 |
| 1902357536 | Ashley Patricia Cota | Nurse Practitioner | 214 Cornelia St., Plattsburgh, NY 12901 | 2016-10-19 |
| 1255703310 | Kenneth Wayne Ackley | Licensed Practical Nurse | 16 Ampersand Drive, Plattsbugh, NY 12901 | 2015-10-28 |
| 1275949448 | Shanni Lee Hicks | Specialist | 63 Arnold Rd, Plattsburgh, NY 12901 | 2014-07-08 |
| Find all providers in zip 12901 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588766679 | Tara Jeanne Brennan | Counselor | 43 Durkee St, Suite 400, Va Medical Clinic, Plattsburgh, NY 12901-2942 | 2006-09-01 |
| 1255443719 | Jessie Notch-leblanc | Counselor | 159 Margaret St Ste 250, Plattsburgh, NY 12901-1874 | 2006-08-31 |
| 1568481810 | Deborah Lee Johnson | Counselor | 16 Ampersand Dr, Plattsburgh, NY 12901-6500 | 2006-07-18 |
| 1164465902 | Clinton County | Counselor | 130 Arizona Ave Ste 1500, Plattsburgh, NY 12903-4908 | 2006-06-13 |
| 1003439001 | Katrina Lopez | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2020-05-26 |
| 1164051066 | James Perales | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2020-04-03 |
| 1538705678 | Carlee Agoney | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2019-11-25 |
| 1982249173 | Marlene Holmes | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2019-11-12 |
| 1407409592 | Chad Michael Rollings | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2019-07-18 |
| 1033778139 | Patrick Mccormick | Counselor | 80 Sharron Ave, Plattsburgh, NY 12901-4700 | 2019-06-12 |
| Find all providers in PLATTSBURGH | ||||
| City | PLATTSBURGH |
| Zip Code | 12901 |
Please comment or provide details below to improve the information on SCOTT BRODERICK.
| 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.