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General NPI Number Information
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NPI Number | 1053462937
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Entity Type | Individual
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Provider Name | JAMES BRADY M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 686 COUNTY ROAD 39A BUILDING 2
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City | SOUTHAMPTON
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State | NY
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Zip | 11968-5703
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Country | US
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Telephone | 631-287-0711
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Fax | 631-287-1080
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Provider Business Mailing Address
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Address Line | PO BOX 6070
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City | SOUTHAMPTON
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State | NY
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Zip | 11969-6070
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Country | US
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Telephone | 631-287-0711
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Fax | 631-287-1080
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 201779
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | 201779
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License Number State | NY
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