Mr. Mariellen M Lane Bradley
Pediatrics | Female
Mr. Mariellen M Lane Bradley is a New York, New York based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Mr. Mariellen M Lane Bradley is
3959 Broadway, New York, New York - 10032-1559. She can be contacted on phone at
212-304-7250 and fax number 212-544-1974.
Mr. Mariellen M Lane Bradley is a sole proprietor of her business.
NPI number (Unique professional ID) for Mr. Mariellen M Lane Bradley is
1851364111 which was assigned by NPPES on 08 Feb, 2006 and it was last updated on 04 Oct, 2021.
Mr. Mariellen M Lane Bradley license number is
178354 for Pediatrics (208000000X) in New York.
Mr. Mariellen M Lane Bradley is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Mr. Mariellen M Lane Bradley basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Mr. Mariellen M Lane Bradley |
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| Gender : | Female |
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Business Address:
Mr. Mariellen M Lane Bradley address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 3959 Broadway
New York, NY, 10032-1559
United States |
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| Phone Number : | 212-304-7250 |
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| Fax Number : | 212-544-1974 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1851364111 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 08 Feb, 2006 |
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| Last Updated On : | 04 Oct, 2021 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Mariellen M Lane Bradley are as mentioned. Primary taxonomy code for Mr. Mariellen M Lane Bradley is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 178354 | NY |
Legacy Identifiers:
Other legacy medical identifiers of Mr. Mariellen M Lane Bradley such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 01370805 | MEDICAID | NC | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 27 W 96th St
New York, NY, 10025-6613
United States |
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| Phone Number : | 212-749-3172 |
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Business Location:
Patients can refer following map for directions to
Mr. Mariellen M Lane Bradley practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.