Individual
MARK BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-1178
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-1178
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1465
MA
Other
Enumeration date
11/08/2006
Last updated
05/07/2008
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