Individual
MR. MARIELLEN M LANE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3959 BROADWAY, NEW YORK, NY 10032-1559
(212) 304-7250
(212) 544-1974
Mailing address
27 W 96TH ST, NEW YORK, NY 10025-6613
(212) 749-3172
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
178354
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01370805
—
NC
Enumeration date
02/08/2006
Last updated
10/04/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us