Eileen Faye Broberg, OT

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT509 Issued in ME

Practice address

68 Pinewood Dr
Auburn, ME 04210-9205

Phone

(207) 784-6076

NPI assigned

Mar 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063536209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 PINEWOOD DR",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042109205",
            "telephone_number": "207-784-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 PINEWOOD DR",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042109205",
            "telephone_number": "207-784-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROBERG",
        "first_name": "EILEEN",
        "middle_name": "FAYE",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ME",
            "license": "OT509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST",
            "identifier": "225X00000X",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas W Breunig, LCSW
• Kristen Brewer, HIS
• Kate Bridgham
• Alayna Rebecca Briggs
• Mary E Britt, ATC
• Alfred L Brodeur, LCSW
• Martha Elizabeth Brodeur, PT
• Kenneth E Brodsky, DO
• Colby Brooks
• Anne JC Brown, MD

• Occupational Therapy Assistant in Auburn, ME
• Providers in Auburn, ME by specialty
• Occupational Therapy Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.