National Provider Identifier
Jonathan D Broder, M.D.
Jonathan D Broder, M.D. is listed in the NPPES registry with a primary specialty of Diagnostic Radiology Physician in Rochester, NY and a listed phone number of (585) 922-3220.
Profile Overview
- NPI
- 1477522514
- Provider Type
- Individual
- Primary Specialty
- Diagnostic Radiology Physician
- Enumeration Date
- March 14, 2006
- Last Updated
- April 30, 2014
Practice Location
- 1425 Portland Ave
- Rochester, NY 14621-3001
Phone: (585) 922-3220
Specialties
- Diagnostic Radiology Physician (2085R0202X)
- Vascular & Interventional Radiology Physician (2085R0204X)
Full Record
- NPI
- 1477522514
- Entity Type
- Individual
- Last Name
- Broder
- First Name
- Jonathan
- Middle Name
- D
- Credential
- M.D.
- Mailing Street Address
- 1425 Portland Ave
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14621-3001
- Mailing Country
- US
- Mailing Phone
- (585) 922-3220
- Mailing Fax
- (585) 922-3518
- Practice Street Address
- 1425 Portland Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621-3001
- Practice Country
- US
- Practice Phone
- (585) 922-3220
- Practice Fax
- (585) 922-3518
- Enumeration Date
- March 14, 2006
- Last Updated
- April 30, 2014
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Diagnostic Radiology Physician (2085R0202X), Vascular & Interventional Radiology Physician (2085R0204X)
- Other Identifiers
- 02057129 (NY)