Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ANDRE EDMOND BROUSSARD, M.D.
Active Sole ProprietorDR. ANDRE EDMOND BROUSSARD, M.D. is a Sports Medicine (Pediatrics) healthcare provider located in NEW YORK, New York. NPI 1710069695 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (Pediatrics) · NEW YORK, NY
Registration Details
- NPI Number
- 1710069695
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 19, 2006 (19.633492955472 yrs)
- Last Updated
- Nov 29, 2007
- License
-
MD126425 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1901 FIRST AVE523NEW YORK, NY, 10029Browse NY providers · Browse ZIP 10029
- Phone
- 2124236228
- Fax
- 2125347831
- Primary Specialty
-
Sports Medicine (Pediatrics)
2080S0010X
Other Sports Medicine (Pediatrics) Providers in NEW YORK, NY
| Name | Credential | NPI |
|---|---|---|
| DR. JAMES J TUCCI | M.D. | 1477528107 |
| DR. JORDAN D METZL | M.D. | 1972566495 |
| DR. TIANA SYMONE WOOLRIDGE | MD, MPH | 1609404185 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.