Individual
ELLEN BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
133 BEACH 129TH ST, ROCKAWAY PARK, NY 11694-1619
(718) 208-8029
Mailing address
424 BEACH 128TH ST, ROCKAWAY PARK, NY 11694-1509
(187) 208-8029
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
344091
NY
Other
Enumeration date
07/12/2021
Last updated
02/08/2022
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