Active NPI
Monica Broderick, M.D.
- Addiction Psychiatry Physician
- Manhasset, NY
National Provider Identifier
1285864140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Psychiatry Physician
- License
- 252729
- Practice address
- 400 Community Dr
Manhasset, NY 11030-3815 - Phone
- (516) 562-3010
- Fax
- (516) 562-3996
- NPI assigned
- Jul 24, 2009
- Last updated
- Jul 24, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Psychiatry Physician | 2084P0802X | 252729 | NY | Primary |
Addresses
Primary practice location
400 Community Dr
Manhasset, NY 11030-3815
Mailing address
400 Community Dr
Manhasset, NY 11030-3815
Phone (516) 562-3010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 252729 | NY | MD | Addiction Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248393600000",
"number": "1285864140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 COMMUNITY DR",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110303815",
"telephone_number": "516-562-3010",
"fax_number": "516-562-3996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 COMMUNITY DR",
"city": "MANHASSET",
"state": "NY",
"postal_code": "110303815",
"telephone_number": "516-562-3010",
"fax_number": "516-562-3996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODERICK",
"first_name": "MONICA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-24",
"last_updated": "2009-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0802X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": "NY",
"license": "252729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhasset, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.