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Individual

JOSEPH THOMAS BRADLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
STUDENT

Contact information

Practice address
827 11TH AVE, NEW YORK, NY 10019-3535
(212) 369-5566
Mailing address
827 11TH AVE, NEW YORK, NY 10019-3535

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
063402
NY

Other

Enumeration date
03/29/2022
Last updated
09/18/2023
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