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Organization

BRUCE L. RADLER, D.P.M.,P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRUCE LOUIS RADLER D.P.M. (PRESIDENT)
(718) 236-2821
Entity
Organization

Contact information

Practice address
6416 17TH AVE, BROOKLYN, NY 11204-2739
(718) 236-2821
(718) 236-1167
Mailing address
6416 17TH AVE, BROOKLYN, NY 11204-2739
(718) 236-2821
(718) 236-1167

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N002355
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00413314
NY
01
0058524
GHI
NY
01
05741
MEDICARE GHI
NY
01
38810
ELDERPLAN HMO
NY
01
N0023551
HIP
NY
Enumeration date
12/13/2006
Last updated
06/02/2008
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