Rebecca Brodoff, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

023014 Issued in NY

Practice address

3692 Bedford Ave Ste P2
Brooklyn, NY 11229-1702

Phone

(646) 837-5557

Fax

(646) 837-5495

NPI assigned

Nov 19, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Center for Anxiety

  • Social Worker
  • Suffern, NY
  • NPI 1194236190
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1053957662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3692 BEDFORD AVE STE P2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291702",
            "telephone_number": "646-837-5557",
            "fax_number": "646-837-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3692 BEDFORD AVE STE P2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291702",
            "telephone_number": "646-837-5557",
            "fax_number": "646-837-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODOFF",
        "first_name": "REBECCA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "023014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@centerforanxiety.org",
            "affiliation": "N",
            "address_1": "3692 Bedford Ave Ste P2",
            "city": "Brooklyn",
            "state": "NY",
            "country_code": "US",
            "postal_code": "112291702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marcelle Raven Broderick
• Rhea Theresa Broderick, RT,LAC
• Konstantin Brodetskiy
• Leah Brodfuehrer
• Miles Brodie
• Aleksandra Brodskaya
• Yevgeniya Brodskaya, PA
• Marta Brodski, M.S., CCC-SLP, TSSLD
• Igor Brodskiy, MD
• Alexander Brodsky, MD

• Clinical Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.