Individual
BRADLEY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
539 US HIGHWAY 9, LANOKA HARBOR, NJ 08734-2211
(609) 549-6266
(609) 549-5600
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB10217800
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0613886
—
NJ
Enumeration date
05/20/2014
Last updated
05/24/2023
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