Healthcare Provider Details

I. General information

NPI: 1073072344
Provider Name (Legal Business Name): CHRISTOPHER PIERCE BRADLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2019
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST
NEW YORK NY
10065-4885
US

IV. Provider business mailing address

575 LEXINGTON AVE STE 500
NEW YORK NY
10022-6102
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-5454
  • Fax:
Mailing address:
  • Phone: 646-962-5401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number341558
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: