Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Andre Edmond Broussard, MD

Individual provider Pediatric Sports Medicine Physician · NPI 1710069695

Dr. Andre Edmond Broussard, MD is a Pediatric Sports Medicine Physician in New York, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1901 First Ave 523
New York, NY 10029
Phone: (212) 423-6228
Fax: (212) 534-7831
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Sports Medicine Physician (primary) Taxonomy 2080S0010X · Licence MD126425 (NY)

Record details

NPI number1710069695
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 19, 2006
Last updated in NPPESNovember 29, 2007

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