Amelia Bradley

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

404504 Issued in NY

Practice address

339 N Broadway
Nyack, NY 10960-1522

Phone

(845) 818-2733

NPI assigned

Mar 30, 2022

Last updated

Oct 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1326788274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 S CROSS RD",
            "city": "STAATSBURG",
            "state": "NY",
            "postal_code": "125806031",
            "telephone_number": "781-414-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 N BROADWAY",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601522",
            "telephone_number": "845-818-2733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Winship St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021353312",
            "country_code": "US",
            "telephone_number": "781-414-1813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "AMELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-10-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404504",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2347475",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neil R. Borodkin, L.AC.
• Lamia Kamel Botros, MD
• Angela Boudounis-Hatzis, D.D.S.
• Naika Boutin
• Elizabeth Bracken, LMSW
• Jonathan Brandes, MD,CAC
• Heidi Brenner
• Elizabeth Ann Bretz, LCSW
• I-Yona Briggs
• David Allen Brizer, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Nyack, NY
• Providers in Nyack, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.