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General NPI Number Information
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NPI Number | 1275281099
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Entity Type | Individual
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Provider Name | DANIEL BRADY PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/10/2022
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 100 E 77TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-1850
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Country | US
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Telephone | 212-434-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 39 ROYDON DR N
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City | MERRICK
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State | NY
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Zip | 11566-1426
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Country | US
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Telephone | 516-662-6668
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 027955
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 027955
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License Number State | NY
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