Individual
DR. BRADY WILLIAM PATENAUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
781 HUDSON AVE., SUITE 2, STILLWATER, NY 12170-0427
(518) 664-4525
(518) 664-1256
Mailing address
PO BOX 427, STILLWATER, NY 12170-0427
(518) 664-4525
(518) 664-1256
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
011152
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10108516
CDPHP
NY
01
—
1065577
ASHN
NY
01
—
204061411
LANDMARK HEALTHCARE
NY
01
—
20406141102
PRISM HEALTH NETWORK
NY
01
—
C11152-8B
WORKERS' COMPENSATION
NY
01
—
NY11152
MVP HEALTH PLAN
NY
01
—
X08P21
BLUE CROSS/BLUE SHIELD
NY
Enumeration date
07/31/2006
Last updated
08/06/2013
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