Individual
RICHARD C BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
188 FRIES MILL RD STE D2, TURNERSVILLE, NJ 08012
(856) 629-7300
(856) 629-8729
Mailing address
188 FRIES MILL RD STE D2, TURNERSVILLE, NJ 08012-2015
(856) 629-7300
(856) 629-8729
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00213000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0114550000
KEYSTONE AND AMERIHEALTH
—
05
—
5172101
—
NJ
01
—
601173
MEDICARE-TYPE UNSPECIFIED
PA
Enumeration date
08/30/2006
Last updated
05/21/2019
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