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NPI Code Detail

MEDICARE: ANTHONY MICHAEL BRADY

MEDICARE: ANTHONY MICHAEL BRADY
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
11223G0001XGeneral Practice Dentistry22DI02950100NJ

General Provider Information

NPI Number : 1659021814
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY MICHAEL BRADY
Provider Business Mailing Address
First Line : 16 FREDERICK CT
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2878
Country : US
Telephone Number : 862-377-4852
Fax Number :
Provider Business Practice Location Address
First Line : 545 ISLAND RD STE 1A
Second Line :
City : RAMSEY
State : NJ
Zip : 07446-2822
Country : US
Telephone Number : 201-778-6443
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2022
Last Update Date : 01/17/2024

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Directions to “ ANTHONY MICHAEL BRADY ” Practice Location

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