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General NPI Number Information
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NPI Number | 1043363906
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Entity Type | Organization
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Legal Business Name | DR BRADLEY A BISK PA
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | BRIGHTON AND BOARDWALK TROPICANA MEDICAL UNIT
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City | ATLANTIC CITY
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State | NJ
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Zip | 08401
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Country | US
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Telephone | 609-340-4475
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Fax | 609-343-5205
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Provider Business Mailing Address
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Address Line | 1701 EAST DRIVE
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City | VENTNOR
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State | NJ
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Zip | 08406
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Country | US
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Telephone | 609-487-0485
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRADLEY A BISK
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Credential | DO
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Telephone | 609-340-4475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MB53615
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License Number State | NJ
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