Individual
MR. HOWARD W BRADNOCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
196-16 HILLSIDE AVE, 1ST FL, HOLLIS, NY 11423-2125
(718) 217-6806
(718) 217-0339
Mailing address
19616 HILLSIDE AVE, FL 1, HOLLIS, NY 11423-2125
(718) 217-6806
(718) 217-0339
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
181072
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01521879
—
NY
01
—
01547
MEDICARE GHI
NY
Enumeration date
02/13/2006
Last updated
06/03/2020
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