Individual
MR. CRAIG BRAITHWAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
506 MALCOLM X BLVD, EMERGENCY DEPT- MLK ROOM 2105H, NEW YORK, NY 10037-1802
(212) 939-2236
Mailing address
PO BOX 954, 638 WADING RIVER HOLLOW ROAD, MIDDLE ISLAND, NY 11953-0954
(631) 924-0624
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003135-1
NY
Other
Enumeration date
01/17/2007
Last updated
07/09/2007
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