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NPI Code Detail

MEDICARE: DR. BRADLEY THOMAS HORAK M.D.

MEDICARE: DR. BRADLEY THOMAS HORAK 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
1208600000XSurgery Physician4301082314MI

General Provider Information

NPI Number : 1972712578
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRADLEY THOMAS HORAK M.D.
Provider Business Mailing Address
First Line : PO BOX 95000-5245
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19195-5245
Country : US
Telephone Number : 212-340-0035
Fax Number :
Provider Business Practice Location Address
First Line : 321 E 34TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10016-4942
Country : US
Telephone Number : 212-340-0035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 08/21/2014

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