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General NPI Number Information
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NPI Number | 1295484582
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Entity Type | Individual
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Provider Name | BRAD ANDREW PRADARELLI MD
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Gender | Male
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Dates
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Enumeration Date | 03/22/2022
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 620 SHADOW LN
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City | LAS VEGAS
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State | NV
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Zip | 89106-4194
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Country | US
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Telephone | 702-259-1228
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Fax | 866-952-2188
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Provider Business Mailing Address
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Address Line | 515 W 59TH ST APT 28A
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City | NEW YORK
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State | NY
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Zip | 10019-1042
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Country | US
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Telephone | 414-881-4306
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 26593
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License Number State | NV
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