Mr. Mariellen M Lane Bradley
Mr. Mariellen M Lane Bradley is a Pediatrics Physician in New York, New York. Licensed in New York. Registered with an NPI since 2006.
- Licensed in
- NY
- In the registry since
- 2006
Practice location Address checks out
3959 BroadwayNew York, NY 10032-1559
Phone: (212) 304-7250
Fax: (212) 544-1974
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Specialties & licences
| Pediatrics Physician (primary) | Taxonomy 208000000X · Licence 178354 (NY) |
|---|
Record details
| NPI number | 1851364111 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | February 8, 2006 |
| Last updated in NPPES | October 4, 2021 |
| Certification date | October 4, 2021 |
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