THERESE LISIEUX BRODERICK (NPI# 1730731225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730731225 |
| Entity Type | Individual |
| Full Name | THERESE LISIEUX BRODERICK |
| Practice Address |
391 W Lawrence St Albany NY 12208-2135 |
| Practice Telephone | 5184822639 |
| Practice Fax Number | 5184822639 |
| Mailing Telephone | 5184822639 |
| Mailing Fax Number | 5184822639 |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
391 W LAWRENCE ST |
| City | ALBANY |
| State | NY |
| Zip Code | 12208-2135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255959045 | Fatima Mahmood | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Department of Internal Medicine, Albany, NY 12208 | 2020-07-08 |
| 1861021784 | Jessica Anne Charles-larose | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Family Medicine, Albany, NY 12208 | 2020-04-02 |
| 1235767211 | Michael Charles Harrington | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept. of Orthopedic Surgery, Albany, NY 12208 | 2020-03-27 |
| 1518594126 | Arkar Htoo | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Pathology, Albany, NY 12208 | 2020-03-24 |
| 1366079030 | Omar Merdan | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave, Dept of Medicine/pediatrics, Albany, NY 12208 | 2020-03-24 |
| 1306473079 | Sergo Gabunia | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of General Surgery, Albany, NY 12208 | 2020-03-24 |
| 1205469392 | Cornell Andre Morris | Social Worker | Albany Stratton Va Medical Center, 113 Holland Avenue, Albany, NY 12208 | 2020-02-17 |
| 1558909234 | St. Peter's Health Partners Medical Associates, P.C. | Surgery | 319 South Manning Blvd Suite 310, Capital Region Colon & Rectal Surgery, Albany, NY 12208 | 2019-12-13 |
| 1912543265 | Meghan Rose Baxter | Social Worker | 58 Academy Rd., Albany, NY 12208 | 2019-11-21 |
| 1245883461 | Gwendolyn Medak | Registered Nurse | 15 New Scotland Ave, Albany, NY 12208 | 2019-07-17 |
| Find all providers in zip 12208 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093355794 | Kevin Tarpey | Specialist/Technologist | 140 New Scotland Ave, Albany, NY 12208-3423 | 2020-01-10 |
| 1174169015 | Cheryl Hurd | Specialist/Technologist | 9 Lawn Ave, Albany, NY 12204-2615 | 2019-11-26 |
| 1861950693 | Grace Elizabeth David | Specialist/Technologist | 29805 Amvets Rd, Albany, LA 70711-4218 | 2019-03-11 |
| 1225595754 | Victoria Kreger | Specialist/Technologist | 6311 Rosemarie St Ne, Albany, OR 97321-7407 | 2019-02-20 |
| 1831653740 | Cheyanne Hope Duckson | Specialist/Technologist | 1211 Highview Dr, Albany, MN 56307-9319 | 2019-01-24 |
| 1235603994 | Jacqueline Coyne | Specialist/Technologist | 12 Airline Dr, Albany, NY 12205-1004 | 2019-01-16 |
| 1982177507 | Matthew Snow | Specialist/Technologist | 1400 Washington Ave Sefcu Arena A25, Albany, NY 12222-0001 | 2019-01-07 |
| 1326537176 | Kimberly Ann Wersted | Specialist/Technologist | 1400 Washington Ave Sefcu A25, Albany, NY 12222-0001 | 2018-05-08 |
| 1659860419 | Patrick Mars | Specialist/Technologist | 1400 Washington Ave Sefcu A-25, Albany, NY 12222-0001 | 2018-05-08 |
| 1174012843 | John Sylak | Specialist/Technologist | 1400 Washington Ave Sefcu Arena A-25, Albany, NY 12222-0001 | 2018-05-08 |
| Find all providers in ALBANY | ||||
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| 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.