Daniel William Bradley
Individual provider Active NPI Contractor · Stroudsburg, PA
NPI 1811296551 · NPPES record last updated Mar 21, 2011
Key facts
- NPI
- 1811296551
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- PA077942 (PA)
- Practice address
- 4994 Shiffer Rd
Stroudsburg, PA 18360-9042 - Phone
- (570) 688-6860
- NPI assigned
- Mar 21, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA077942 | PA | MD | Vehicle Modifications Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | PA077942 | PA | Yes |
| Home Modifications Contractor | 171WH0202X | PA077942 | PA | |
| Vehicle Modifications Contractor | 171WV0202X | PA077942 | PA |
Addresses
Primary practice location
4994 Shiffer Rd
Stroudsburg, PA 18360-9042
Mailing address
4994 Shiffer Rd
Stroudsburg, PA 18360-9042
Phone (570) 688-6860
Other providers in Stroudsburg, PA
- Krista Bott
- Steven Richard Bowers
- Abbey Lynn Boyd
- Jill Boyle
- Margaret Elizabeth Bradley-Van Orman
- Zach Braunstein
- Brennan Family Chiropractic LLC
- Andrea Brennan
- Ryan Andrew Brennan
- Emily Brettell
All providers in Stroudsburg, PA · Contractor in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.