Healthcare Provider Details

I. General information

NPI: 1457318487
Provider Name (Legal Business Name): BRADLEY ALAN SCHIFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 BAINBRIDGE AVE MAP BLDG 3RD FLOOR
BRONX NY
10467-2404
US

IV. Provider business mailing address

16 HUDSON ST APT 2E
NEW YORK NY
10013-3886
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-4646
  • Fax:
Mailing address:
  • Phone: 212-513-1418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number233619
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: