Braddock, Edward Roy
Braddock, Edward Roy is an individual health care provider with primary practice located at 124 Loughridge Dr , Beaver Falls PA 15010-1422. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Braddock, Edward Roy can be contacted via phone (724) 846-5887.Contact Information
Primary practice address
124 Loughridge Dr
Beaver Falls PA 15010-1422
Phone: (724) 846-5887
Fax: (724) 843-9276
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT006762L | Pennsylvania |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT010934 | Ohio |
Profile Details
| NPI number | 1497707228 |
|---|---|
| LBN Legal business name | Braddock, Edward Roy |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2006 |
| Last updated | Dec 7th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497707228 | NPPES |
| Pennsylvania | Other | 1627513 | HIGHMARK BC/BS |
| Pennsylvania | Other | 000000359936 | HIGHMARK BC/BS |
| Pennsylvania | Other | P00272193 | HIGHMARK BC/BS |
| Pennsylvania | MEDICAID | 2552830 | HIGHMARK BC/BS |
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