MEDICARE: DR. BRIAN MICHAEL BRADY M.D.

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	207R00000X	Internal Medicine Physician	155701	NY

General Provider Information

NPI Number	:	1720065378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN MICHAEL BRADY M.D.

Provider Business Mailing Address
First Line	:	700 WHITE PLAINS RD
Second Line	:	SUITE 5
City	:	SCARSDALE
State	:	NY
Zip	:	10583-5063
Country	:	US
Telephone Number	:	914-723-2446
Fax Number	:	914-725-7457

Provider Business Practice Location Address
First Line	:	700 WHITE PLAINS RD
Second Line	:	SUITE 5
City	:	SCARSDALE
State	:	NY
Zip	:	10583-5063
Country	:	US
Telephone Number	:	914-723-2446
Fax Number	:	914-725-7457

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2005
Last Update Date	:	12/06/2013

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