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General NPI Number Information
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NPI Number | 1538393194
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Entity Type | Individual
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Provider Name | JOANIE GARCIA BRADSHAW P.A.
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Gender | Female
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 779 NORTH ST
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City | GREENWICH
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State | CT
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Zip | 06831-3105
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Country | US
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Telephone | 646-844-9602
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Fax | 646-846-2310
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Provider Business Mailing Address
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Address Line | 204 CORLIES AVE
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City | PELHAM
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State | NY
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Zip | 10803-1904
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Country | US
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Telephone | 646-844-9602
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Fax | 646-846-2310
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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 | 013234
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License Number State | NY
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