Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 0101263882 | VA |
Y | 207T00000X | Neurosurgeon | 25MA10443200 | NJ |
NPI | 1013143627 |
---|---|
Provider Name | Dr. Bradley Allen Dengler |
First Address | Camden, NJ 08103-1088 |
Second Address | Camden, NJ 08103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2009 |
Last Update Date | 01/10/2019 |