Individual
MR. BRAD M DENOVIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
3757 CARMAN RD, SUITE 100, SCHENECTADY, NY 12303-5438
(518) 355-7063
(518) 357-0646
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002585
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000491896001
BSNENY
NY
05
—
02217036
—
NY
01
—
070418000074
FIDELIS
NY
01
—
356360
MVP HEALTHCARE
NY
Enumeration date
08/27/2006
Last updated
01/25/2018
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