Bradshaw, Charles B

Bradshaw, Charles B is an individual health care provider with primary practice located at 750 E Adams St Department Of Neurology, Syracuse NY 13210-2306. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Bradshaw, Charles B can be contacted via phone (315) 464-5016.

Contact Information

Primary practice address
750 E Adams St Department Of Neurology Syracuse NY 13210-2306
Phone: (315) 464-5016
Fax: (315) 464-5355
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 010159 New York

Profile Details

NPI number 1780632851
LBN Legal business name Bradshaw, Charles B
Credentials PH.D
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jan 23rd, 2009 - about 16 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1780632851 NPPES
New York MEDICAID 01207905

Popular Providers