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General NPI Number Information
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NPI Number | 1902975550
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Entity Type | Individual
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Provider Name | JAY BRADLEY FOOTE MD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 3302 STEUBEN AVE
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City | BRONX
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State | NY
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Zip | 10467-2806
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Country | US
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Telephone | 718-920-4263
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Fax | 718-920-6538
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Provider Business Mailing Address
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Address Line | 3302 STEUBEN AVE
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City | BRONX
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State | NY
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Zip | 10467-2806
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Country | US
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Telephone | 718-231-6964
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Fax | 914-861-2550
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 171321
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License Number State | NY
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