Bradley Wayne Anthony, BOCPO
in Westbury, NY. Individual provider (NPI-1).
NPI number1699246728
StatusActive
Last updated in NPPESDec 16, 2018
Details
- NPI
- 1699246728
- Entity type
- Individual (NPI-1)
- Name
- Bradley Wayne Anthony
- Credential
- BOCPO
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 16, 2018
- Last updated
- Dec 16, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Z00000X | – | – | Yes | |
| 224P00000X | Prosthetist | – | – |
Practice location
813 Carman Ave Unit AWestbury, NY 11590-6447
Phone 516-333-7200 · Fax 516-333-7277
Mailing address
19 Hope LnHicksville, NY 11801-6110
Phone 903-880-4927
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