Individual
BENJAMIN BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
707 E MAIN ST, MIDDLETOWN, NY 10940-2650
(845) 333-1300
Mailing address
7 SYCAMORE ST, GARNERVILLE, NY 10923-2008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
017055
NY
Other
Enumeration date
09/27/2013
Last updated
09/27/2013
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