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Monique Broussard
NPI 1841172855 · on the registry since 2025 · sole proprietor
Practice
- Address
- 760 Montauk Hwy
Water Mill, NY 11976 - Phone
- (347) 754-7952
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 101YM0800X
101YM0800X
- Also registered as
- 101YP1600X
101YP2500X
103T00000X
103TP2701X
102L00000X
171400000X - Licence states on file
- NULL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-07-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York