Active NPI
Kathleen E Bradway
- Pharmacist
- Hudson Falls, NY
National Provider Identifier
1730369364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 049170
- Practice address
- 1262 Dix Ave
Hudson Falls, NY 12839-9618 - Phone
- (518) 747-0292
- NPI assigned
- Nov 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 049170 | NY | Primary |
Addresses
Primary practice location
1262 Dix Ave
Hudson Falls, NY 12839-9618
Mailing address
84 Perkins Dr
Hudson Falls, NY 12839-2646
Phone (518) 480-3350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 049170 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 049170 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1730369364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84 PERKINS DR",
"city": "HUDSON FALLS",
"state": "NY",
"postal_code": "128392646",
"telephone_number": "518-480-3350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1262 DIX AVE",
"city": "HUDSON FALLS",
"state": "NY",
"postal_code": "128399618",
"telephone_number": "518-747-0292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADWAY",
"first_name": "KATHLEEN",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-12",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "049170",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "049170",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hudson Falls, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.