Individual
MR. BRADLEY JUDE BACANAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1070 CLIFTON AVE, SUITE A1, CLIFTON, NJ 07013-3619
(973) 246-6565
Mailing address
209 COMLY RD, APT K31, LINCOLN PARK, NJ 07035-1166
(973) 707-8249
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01194900
NJ
Other
Enumeration date
09/16/2014
Last updated
07/17/2016
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