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General NPI Number Information
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NPI Number | 1821257320
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Entity Type | Organization
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Legal Business Name | GIOMBETTI & BRADY PEDIATRICS PLLC
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 208 DELAWARE AVE
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City | DELMAR
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State | NY
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Zip | 12054-1221
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Country | US
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Telephone | 518-439-5611
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Fax | 518-439-9576
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Provider Business Mailing Address
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Address Line | 208 DELAWARE AVE
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City | DELMAR
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State | NY
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Zip | 12054-1221
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Country | US
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Telephone | 518-439-5611
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Fax | 518-439-9576
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. KATHLEEN BRADY
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Credential | MD
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Telephone | 518-439-5611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | NY
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