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General NPI Number Information
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NPI Number | 1689257941
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Entity Type | Individual
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Provider Name | ERIC STEVEN BRADWAY OTR/L, MS
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Gender | Male
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Dates
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Enumeration Date | 05/04/2021
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 415 W LANDIS AVE STE 101A
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City | VINELAND
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State | NJ
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Zip | 08360-8140
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Country | US
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Telephone | 856-500-3800
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Fax | 856-213-6549
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Provider Business Mailing Address
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Address Line | 224 STRAWBRIDGE DR STE 100
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City | MOORESTOWN
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State | NJ
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Zip | 08057-4602
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Country | US
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Telephone | 856-677-4000
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Fax | 856-234-3014
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC017409
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR00966500
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License Number State | NJ
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