Individual
MR. RICHMOND BRADSHAW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
273 HEBERTON AVE, STATEN ISLAND, NY 10302-1809
(718) 412-3170
Mailing address
273 HEBERTON AVE, STATEN ISLAND, NY 10302-1809
(718) 412-3170
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37015
NY
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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