Individual
DR. BRADLEY HOLMES PADDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
182 STEELE AVE LOWR LEVEL, GLOVERSVILLE, NY 12078-4617
(518) 725-8656
(518) 773-7824
Mailing address
242 E STATE ST EXT, GLOVERSVILLE, NY 12078-6039
(518) 725-8656
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
150053
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00709682
—
NY
01
—
J400554086
MEDICARE PIN-NLH
NY
Enumeration date
03/28/2006
Last updated
02/18/2021
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