Individual
TRACY ALISON BRADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 SANSOM ST STE 239, PHILADELPHIA, PA 19107-5002
(215) 955-6844
(215) 923-6225
Mailing address
1020 SANSOM ST STE 239, PHILADELPHIA, PA 19107-5002
(215) 955-2526
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD466975
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/19/2016
Last updated
07/05/2019
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