Individual
BRADLEY WAYNE ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BOCPO
Contact information
Practice address
813 CARMAN AVE UNIT A, WESTBURY, NY 11590-6447
(516) 333-7200
(516) 333-7277
Mailing address
19 HOPE LN, HICKSVILLE, NY 11801-6110
(903) 880-4927
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
224P00000X
Prosthetist
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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