Individual
STEPHEN T BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, FACCP, FSCAI
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
162690
NY
207RC0000X
Cardiovascular Disease Physician
36435
SC
207RI0011X
Interventional Cardiology Physician
162690
NY
207RI0011X
Interventional Cardiology Physician
Primary
36435
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02186125
—
NY
01
—
060067418
RR MEDICARE
NY
01
—
060071214
RR MEDICARE
MA
05
—
2011824
—
MA
01
—
CC6110
MEDICARE RR
SC
05
—
GP0965
—
SC
Enumeration date
09/13/2005
Last updated
07/09/2020
Update your record
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