Melissa Broderick, PT, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

025723 Issued in NY

Practice address

2900 Westchester Avenue
Suite 108
Purchase, NY 10577-2552

Phone

(914) 364-0504

Fax

(914) 828-0100

NPI assigned

Nov 7, 2008

Last updated

Nov 21, 2016By the provider in NPPES

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

Other names 1

• Dr. Melissa Kang Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Power of Movement Physical Therapy, P.C.

  • Specialist
  • Purchase, NY
  • NPI 1114469376
  NPD (past) Authorized official

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1710131461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 STONEHOLLOW DRIVE",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105092678",
            "telephone_number": "914-364-0504",
            "fax_number": "914-828-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 WESTCHESTER AVENUE",
            "address_2": "SUITE 108",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772552",
            "telephone_number": "914-364-0504",
            "fax_number": "914-828-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "MELISSA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-07",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NY",
            "license": "025723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "KANG",
            "prefix": "DR.",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Courtney Anne Brady
• Cindy Brand
• Brauer Dermatology, PLLC.
• Theresa H Brewer, OTR/L
• Bridge Medical Distribution Network, LLC
• Sherri Brodsky
• Charles Brown, PA-C
• Tricia Bucud
• Chantelle Marie Bueno, OTR/L
• Danielle Buffamante, MA, CCC-SLP

• Pediatric Physical Therapist in Purchase, NY
• Providers in Purchase, NY by specialty
• Pediatric Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.