Healthcare Provider Details

I. General information

NPI: 1861679003
Provider Name (Legal Business Name): J. EDUARDO BRAVO AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ED BRAVO AU.D.

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHASE RD
SCARSDALE NY
10583-4156
US

IV. Provider business mailing address

1 CHASE RD
SCARSDALE NY
10583-4156
US

V. Phone/Fax

Practice location:
  • Phone: 914-472-4444
  • Fax: 914-931-3485
Mailing address:
  • Phone: 914-472-4444
  • Fax: 914-931-3485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number001303-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: