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NPI Code Detail

MEDICARE: CYNTHIA NEUS BRADLEY

MEDICARE: CYNTHIA NEUS BRADLEY
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
1225X00000XOccupational Therapist100297MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19G925BROTHERMNBCBS
26402870OTHERMNMEDICA
3HP43926OTHERMNHP

General Provider Information

NPI Number : 1306964614
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA NEUS BRADLEY
Provider Business Mailing Address
First Line : 709 UNIVERSITY AVE W
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-4804
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 709 UNIVERSITY AVE W
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-4804
Country : US
Telephone Number : 651-227-8471
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 07/08/2007

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Directions to “ CYNTHIA NEUS BRADLEY ” Practice Location

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