Broome Developmental Center

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

006396-1 Issued in NY

Legal business name

BROOME DEVELOPMENTAL CENTER

Practice address

249 Glenwood Rd
Binghamton, NY 13905-1603

Phone

(607) 770-0348

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mangala Puttaniah, MD

Title

Medical Director

Phone

(607) 770-0348

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1689875809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 GLENWOOD RD",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139051603",
            "telephone_number": "607-770-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 GLENWOOD RD",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139051603",
            "telephone_number": "607-770-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOME DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "PUTTANIAH",
        "authorized_official_first_name": "MANGALA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "607-770-0348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NY",
            "license": "006396-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Broome County Health Dept.
• Broome County Mental Health
• Broome County Mental Health Department
• Broome County Office for Aging
• Broome Ddso Clinic
• Broome Developmental Services
• Broome Developmental Services High Risk Birth Clinic
• Broome Gastroenterology Assoc, PC
• Broome Health Care Service LLC
• Broome Neurosciences, P C

• Nursing Facility/Intermediate Care Facility in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Nursing Facility/Intermediate Care Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.