Individual
ANNEMARIE C BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
15 WILLOW ST, SELDEN, NY 11784-2807
(631) 730-0147
Mailing address
15 WILLOW ST, SELDEN, NY 11784-2807
(631) 730-0147
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310111-1
NY
Other
Enumeration date
07/12/2013
Last updated
07/12/2013
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