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NPI Code Detail

MEDICARE: LACEY BRADFORD

MEDICARE: LACEY BRADFORD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse819156NY

General Provider Information

NPI Number : 1033068697
Entity Type Code : Individual
Provider Name (Legal Business Name) : LACEY BRADFORD
Provider Business Mailing Address
First Line : 12 BELMORE WAY
Second Line :
City : ROCHESTER
State : NY
Zip : 14612-2363
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1555 LONG POND RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14626-4164
Country : US
Telephone Number : 585-723-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2026
Last Update Date : 01/27/2026

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Directions to “ LACEY BRADFORD ” Practice Location

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