Bradley D Fenster MD PHD PC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

MD073510L Issued in PA

Legal business name

BRADLEY D FENSTER MD PHD PC

Practice address

107 Loomis St
Wilkes Barre, PA 18702-4637

Phone

(570) 822-6036

NPI assigned

Sep 8, 2008

Last updated

Sep 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bradley D Fenster, MD PHD

Title

Owner

Phone

(570) 822-6036

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1700034246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 LOOMIS ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187024637",
            "telephone_number": "570-822-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 LOOMIS ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187024637",
            "telephone_number": "570-822-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY D FENSTER MD PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "FENSTER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-822-6036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD PHD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "PA",
            "license": "MD073510L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daman Ray Bowman, DO
• Alexei Boylan, MS, RDN, LDN
• Grace K. Boyle, M.D.
• Julie Ann Boyle, R.D.
• William Brack
• James O. Brady, M.D.
• Tyler Brady I
• William F Brazerol, MD
• Amy Brazil Golden
• Brent Smith CRNP (Mindspace Medical)

• Cardiovascular Disease Physician in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Cardiovascular Disease Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.