Provider Demographics
NPI:1720049117
Name:BRODSKY, VALERIE A (DO)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:A
Last Name:BRODSKY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 E UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2000
Mailing Address - Country:US
Mailing Address - Phone:480-965-3346
Mailing Address - Fax:480-965-8914
Practice Address - Street 1:451 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-2000
Practice Address - Country:US
Practice Address - Phone:480-965-3346
Practice Address - Fax:480-965-8914
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4258207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPTANZ131973Medicare PIN