MEDICARE: EXHALE PSYCHIATRY SC

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
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1053255273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXHALE PSYCHIATRY SC

Provider Business Mailing Address
First Line	:	9000 W. CHESTER ST. SUITE 100
Second Line	:	PMB #17042909
City	:	MILWAUKEE
State	:	WI
Zip	:	53214
Country	:	US
Telephone Number	:	414-262-5385
Fax Number	:	458-231-8620

Provider Business Practice Location Address
First Line	:	2026 MARTHA WASHINGTON DRIVE
Second Line	:	PMB #17042909
City	:	WAUWATOSA
State	:	WI
Zip	:	53213
Country	:	US
Telephone Number	:	414-262-5385
Fax Number	:	458-231-8620

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NICHOLAS BRACCIANO
Credential	:	MD
Telephone Number	:	414-210-8419

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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