Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 193257 | NY |
NPI | 1013014836 |
---|---|
Provider Name | Jonathan A Bradlow |
First Address | Bronx, NY 10468-1247 |
Second Address | Bronx, NY 10468 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 29/03/2013 |