Christine Broderick, PT

Individual provider Active NPI Physical Therapist · Ramsey, NJ

NPI 1235249798 · NPPES record last updated Jan 4, 2012

Key facts

NPI
1235249798
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
700C Lake St
Ramsey, NJ 07446-1372
Phone
(201) 962-7454
Fax
(201) 962-7455
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Yes

Addresses

Primary practice location

700C Lake St
Ramsey, NJ 07446-1372

Mailing address

112 Carter Rd
Haskell, NJ 07420-1060

Other identifiers

IdentifierTypeStateIssuer
40QA00928600OtherNJLICENSE #

Other providers in Ramsey, NJ

All providers in Ramsey, NJ · Physical Therapist in New Jersey

Sources for this page

Verify at the official NPI Registry.