National Provider Identifier

Mary Siobhan Broderick, RN, CDCES

Mary Siobhan Broderick, RN, CDCES is listed in the NPPES registry with a primary specialty of Diabetes Educator Registered Nurse in Batavia, NY and a listed phone number of (585) 344-5331.

NPI 1720749229Batavia, NYDiabetes Educator Registered Nurse

Profile Overview

NPI
1720749229
Provider Type
Individual
Primary Specialty
Diabetes Educator Registered Nurse
Enumeration Date
January 06, 2022
Last Updated
October 10, 2023

Practice Location

  • 164 Washington Ave
  • Batavia, NY 14020-2113

Phone: (585) 344-5331

Specialties

  • Diabetes Educator Registered Nurse (163WD0400X)
  • Registered Nurse (163W00000X)
Full Record
NPI
1720749229
Entity Type
Individual
Last Name
Broderick
First Name
Mary
Middle Name
Siobhan
Credential
RN, CDCES
Mailing Street Address
164 Washington Ave
Mailing City
Batavia
Mailing State
NY
Mailing ZIP Code
14020-2113
Mailing Country
US
Mailing Phone
(585) 344-5331
Practice Street Address
164 Washington Ave
Practice City
Batavia
Practice State
NY
Practice ZIP Code
14020-2113
Practice Country
US
Practice Phone
(585) 344-5331
Enumeration Date
January 06, 2022
Last Updated
October 10, 2023
Sex
Female
Sole Proprietor
No
Certification Date
October 10, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Diabetes Educator Registered Nurse (163WD0400X), Registered Nurse (163W00000X)