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Individual

DR. BRUCE LOUIS RADLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
6416 17TH AVE, BROOKLYN, NY 11204-2739
(718) 236-2821
(718) 236-1167
Mailing address
6416 17TH AVE, BROOKLYN, NY 11204-2739
(718) 236-2821
(718) 236-1167

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
N0023551
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00413314
NY
01
0058524
GHI
NY
01
38810
ELDERPLAN HMO
NY
01
N0023551
HIP
NY
01
P26231
EMPIRE BC/BS
NY
Enumeration date
10/16/2006
Last updated
07/08/2007
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