Individual
BRADLEY ANTHONY REID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3007 ELY AVE, BRONX, NY 10469-3259
(347) 603-5328
Mailing address
3007 ELY AVE, BRONX, NY 10469-3259
(347) 603-5328
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
296429-1
NY
Other
Enumeration date
03/23/2009
Last updated
09/16/2009
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