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General NPI Number Information
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NPI Number | 1730244328
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Entity Type | Individual
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Provider Name | JEFFREY NORMAN BRADSHAW M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 132 W 96TH ST
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City | NEW YORK
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State | NY
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Zip | 10025-6418
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Country | US
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Telephone | 212-662-7790
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Fax | 212-662-3142
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Provider Business Mailing Address
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Address Line | 132 W 96TH ST
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City | NEW YORK
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State | NY
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Zip | 10025-6418
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Country | US
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Telephone | 212-662-7790
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Fax | 212-662-3142
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 127851
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License Number State | NY
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