Geraldine Anne Brodarick, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

564069 Issued in NY

Practice address

490 Manor Hill LN
Mattituck, NY 11952-2468

Phone

(631) 566-8875

NPI assigned

Oct 8, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East End RN Care P.C.

  • Point of Service
  • Mattituck, NY
  • NPI 1508018383
  NPD (past)

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1689825697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 WATER TER",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119714942",
            "telephone_number": "631-765-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 MANOR HILL LN",
            "city": "MATTITUCK",
            "state": "NY",
            "postal_code": "119522468",
            "telephone_number": "631-566-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODARICK",
        "first_name": "GERALDINE",
        "middle_name": "ANNE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "564069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Marie Battaglia, LCSW
• Phyllis Beck, LPN
• Terry Becker
• Holly A Berdinka, MPT
• Alex Boukas, DDS
• Luigi Buono, DO
• Calming Waters LCSW
• Ava Cardinale
• Cynthia Carlson, M.D.
• Philip J Centonze, DMD

• All providers in Mattituck, NY
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.