Avery C Broderick
Physician Assistant in Killingworth, Connecticut
1356022198- Practice location
- 63 Parker Hill Road Ext, Killingworth, CT 06419-2311
- Phone
- 203-937-2309
- Fax
- —
- Last updated
- November 6, 2025
Avery Caroline Broderick is a Physician Assistant based in Killingworth, CT. Avery Caroline Broderick practices in Killingworth, CT. The NPI Number for Avery Caroline Broderick is 1356022198 and holds a License No. 6173 (CT). The current practice location address for Avery Caroline Broderick is 63 Parker Hill Road Ext, Killingworth, CT 06419-2311 and can be reached out via phone at 203-937-2309.
Provider Profile Details
- NPI Number
- 1356022198
- Provider Name
- Avery Caroline Broderick
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 63 Parker Hill Road Ext, Killingworth, CT 06419-2311
- Phone Number
- 203-937-2309
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- July 25, 2023
- Last Update Date
- November 6, 2025
- Certification Date
- November 6, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 63 Parker Hill Road Ext
Killingworth, CT 06419-2311 - City
- Killingworth
- State
- Connecticut
- Zip
- 06419-2311
- Phone Number
- 203-937-2309
Provider Business Mailing Address Details
- Address
- 5 Pamela Ln
South Salem, NY 10590-1115 - City
- South Salem
- State
- NY
- Zip
- 10590-1115
- Phone Number
- 631-697-1468
License Information
- License Number
- 6173
- License State
- CT
- Taxonomy
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Avery C Broderick?
The NPI number of Avery C Broderick is 1356022198. It was assigned on July 25, 2023 and is currently active in the NPPES registry.
What is the specialty of Avery C Broderick?
Avery C Broderick is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in CT under license number 6173.
Where does Avery C Broderick practice?
The practice location is 63 Parker Hill Road Ext, Killingworth, CT 06419-2311. The office can be reached at 203-937-2309 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1356022198 directly on the NPPES registry website.