Kathryn A Brodt, RPH
Individual provider Active NPI Pharmacist · Rome, NY
NPI 1407995103 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1407995103
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 027934-1 (NY)
- Practice address
- 1500 N James St
Rome, NY 13440-2844 - Phone
- (315) 338-7690
- Fax
- (315) 338-7697
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027934-1 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 027934-1 | NY | Yes |
Addresses
Primary practice location
1500 N James St
Rome, NY 13440-2844
Mailing address
16 Jones Rd
Sauquoit, NY 13456-3424
Phone (315) 338-7690
Other providers in Rome, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.