Daniel William Bradley

Primary specialty

ContractorTaxonomy code 171W00000X

License

PA077942 Issued in PA

Practice address

4994 Shiffer Rd
Stroudsburg, PA 18360-9042

Phone

(570) 688-6860

NPI assigned

Mar 21, 2011

Last updated

Mar 21, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1811296551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4994 SHIFFER RD",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183609042",
            "telephone_number": "570-688-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4994 SHIFFER RD",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183609042",
            "telephone_number": "570-688-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "DANIEL",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-21",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "PA",
            "license": "PA077942",
            "primary": true
        },
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "PA",
            "license": "PA077942",
            "primary": false
        },
        {
            "code": "171WV0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Vehicle Modifications",
            "state": "PA",
            "license": "PA077942",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Bott, M.D.
• Steven Richard Bowers, D.O.
• Abbey Lynn Boyd, DPM
• Jill Boyle, APN
• Margaret Elizabeth Bradley-Van Orman, RN699541
• Zach Braunstein
• Brennan Family Chiropractic LLC
• Andrea Brennan, D.C.
• Ryan Andrew Brennan, D.C
• Emily Brettell

• Contractor in Stroudsburg, PA
• Providers in Stroudsburg, PA by specialty
• Contractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; 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.