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BROOME SURGERY & BREAST CARE, P.C.
NPI 1790960839
Specialist in Johnson City, NY

Active since January 08, 2008
240 RIVERSIDE DR, SUITE 3, JOHNSON CITY, NY 13790(607) 729-0443(607) 766-9395 Get Directions Write a Review

NPPES record last updated: February 7, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Broome Surgery & Breast Care, P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROOME SURGERY & BREAST CARE, P.C. (NPI 1790960839) is a healthcare organization registered as a specialist in Johnson City, New York and active in the NPI registry since January 2008. The organization lists Ghassem Mangouri, President, as its authorized official.

NPPES Registry Identity

NPI1790960839
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameBROOME SURGERY & BREAST CARE, P.C.
Location Address240 RIVERSIDE DR, SUITE 3Johnson City, NY 13790-2732
Mailing Address240 Riverside Dr, Suite 3Johnson City, NY 13790-2732 · (607) 729-0443 · Fax (607) 766-9395
Phone(607) 729-0443
Fax(607) 766-9395
Organization SubpartNo
Authorized OfficialGhassem MangouriPresident · (607) 729-0443
Enumeration DateJanuary 8, 2008
Last NPPES UpdateFebruary 7, 2008
✔ NPI 1790960839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 0154223
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
240 RIVERSIDE DR, Johnson City, NY 13790
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Other Identifiers 2

Medicare UPINB83244NY
Medicaid00775599NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHEN G FEDEROWICZ MD
Orthopaedic Surgery
240 RIVERSIDE DR
JOHNSON CITY, NY 13790
Broome County (607) 798-9356
KYUNG IN KIM MD
Orthopaedic Surgery
240 RIVERSIDE DR
JOHNSON CITY, NY 13790
Broome County (607) 798-9356
TYLER RATHMELL
Physician Assistant
240 RIVERSIDE DR
JOHNSON CITY, NY 13790
Broome County (607) 798-9356
MARK VINCENT WILSON MD
Orthopaedic Surgery
240 RIVERSIDE DR
JOHNSON CITY, NY 13790
Broome County (607) 798-9356
SCOTT F. HAGE O.D.
Optometrist
240 RIVERSIDE DR, SUITE ONE
JOHNSON CITY, NY 13790
Broome County (607) 729-2102
MS. MINDI ANNE DONAHUE P.A.
Physician Assistant
240 RIVERSIDE DR
JOHNSON CITY, NY 13790
Broome County (607) 798-9356
DR. STEPHEN ALAN LISMAN PH.D.
Psychologist (Clinical)
240 RIVERSIDE DR, SUITE 2
JOHNSON CITY, NY 13790
Broome County (607) 797-1652
MRS. KARLI RENA CAMPBELL PA-C
Physician Assistant
240 RIVERSIDE DR
JOHNSON CITY, NY 13790
Broome County (607) 798-9356

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Broome Surgery & Breast Care, P.C.'s NPI number?

The NPI number for Broome Surgery & Breast Care, P.C. is 1790960839. It was assigned to this organization in the NPPES registry on January 8, 2008.

Where is Broome Surgery & Breast Care, P.C. located?

Broome Surgery & Breast Care, P.C. is located at 240 Riverside Dr Suite 3, Johnson City, NY 13790. The listed phone number is (607) 729-0443.

What is Broome Surgery & Breast Care, P.C.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Broome Surgery & Breast Care, P.C. was last updated on February 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.