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General NPI Number Information
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NPI Number | 1508274838
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Entity Type | Individual
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Provider Name | SHADEL BRADFORD LPN
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Gender | Female
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Dates
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Enumeration Date | 07/30/2014
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 839 FLOWER CITY PARK
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City | ROCHESTER
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State | NY
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Zip | 14615-3624
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Country | US
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Telephone | 585-317-1961
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Fax |
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Provider Business Mailing Address
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Address Line | 63 ALLANDALE DR
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City | ROCHESTER
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State | NY
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Zip | 14624-2052
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Country | US
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Telephone | 585-664-9004
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 10 315653
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License Number State | NY
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