National Provider Identifier

Andi Dora Broffman

Andi Dora Broffman is listed in the NPPES registry with a primary specialty of Social Worker in Ithaca, NY and a listed phone number of (607) 793-4260.

NPI 1639990229Ithaca, NYSocial Worker

Profile Overview

NPI
1639990229
Provider Type
Individual
Primary Specialty
Social Worker
Enumeration Date
October 17, 2024
Last Updated
October 17, 2024

Practice Location

  • 16 Cinema Drive, Suite 119
  • Suite 119
  • Ithaca, NY 14850

Phone: (607) 793-4260

Mailing Address

  • 103 Lafayette Ave
  • Geneva, NY 14456-1610

Specialties

  • Social Worker (104100000X)
Full Record
NPI
1639990229
Entity Type
Individual
Last Name
Broffman
First Name
Andi
Middle Name
Dora
Mailing Street Address
103 Lafayette Ave
Mailing City
Geneva
Mailing State
NY
Mailing ZIP Code
14456-1610
Mailing Country
US
Mailing Phone
(716) 868-7191
Practice Street Address
16 Cinema Drive, Suite 119
Practice Address Line 2
Suite 119
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850
Practice Country
US
Practice Phone
(607) 793-4260
Enumeration Date
October 17, 2024
Last Updated
October 17, 2024
Sex
Female
Sole Proprietor
No
Certification Date
October 17, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Social Worker (104100000X)