Douglas M Brodman, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

021902 Issued in NY

Practice address

333 E 43Rd St Lbby 1
New York, NY 10017-4819

Phone

(917) 599-7743

NPI assigned

Sep 6, 2016

Last updated

May 2, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1467909556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 2ND AVE APT 56",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166349",
            "telephone_number": "917-599-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E 43RD ST LBBY 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100174819",
            "telephone_number": "917-599-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODMAN",
        "first_name": "DOUGLAS",
        "middle_name": "M",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-06",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott E Brodie, MD
• Tammie F Brodie, ANP-BC
• Susan Brodlie, MSRD, CNSC
• Samantha Gayl Brodlieb, MA.ED., BCBA
• Brodman Friedman Kim MD LLP
• Karen F Brodman, M.D.
• Michael L. Brodman, M.D.
• Nirmala Brodman
• Shamika Brodnax
• Lia Grace Brodrick, LMSW

• Clinical Psychologist in New York, NY
• Providers in New York, 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 May 2, 2019; 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.

Verify at the official NPI Registry.