Individual provider · NPI-1

Michelle Bradford

Specialist/Technologist, Other · Forest Hills, NY

NPI number1295264018
StatusActive
Last updated in NPPESJun 6, 2017

Details

NPI
1295264018
Entity type
Individual (NPI-1)
Name
Michelle Bradford
Sex
Female
Sole proprietor
No
Enumeration date
Jun 6, 2017
Last updated
Jun 6, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
246Z00000X Specialist/Technologist, Other––Yes

Practice location

7000 Austin St Ste 202
Forest Hills, NY 11375-1022

Phone 631-385-7780

Mailing address

10 Eisenhower Ave
Brentwood, NY 11717-3317

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Other Specialist/Technologist, Other providers in Forest Hills, NY