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Individual

BRADY GERONIMO CASE

Active
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Individual

BRADY GERONIMO CASE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
231158
NY
2084P0804X
Child & Adolescent Psychiatry Physician
2MA08516300
NJ
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD12323
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MEDICAL LICENSE
MD12323
RI
Enumeration date
04/16/2007
Last updated
11/15/2022
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