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General NPI Number Information
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NPI Number | 1801230750
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Entity Type | Individual
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Provider Name | JOSEPH BRACKER D.O
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Gender | Male
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 355 GRAND ST
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City | JERSEY CITY
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State | NJ
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Zip | 07302-4321
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Country | US
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Telephone | 201-915-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5024
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City | NEW YORK
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State | NY
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Zip | 10087-5024
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Country | US
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Telephone | 800-627-4470
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MB12270700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 287459
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License Number State | NY
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Taxonomy #3
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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 #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | OS21063
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License Number State | FL
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