Bradshaw, John Andrew
Bradshaw, John Andrew is an individual health care provider with primary practice located at 10 Graham Rd W , Ithaca NY 14850-1055. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Bradshaw, John Andrew can be contacted via phone (607) 257-2188.Contact Information
Primary practice address
10 Graham Rd W
Ithaca NY 14850-1055
Phone: (607) 257-2188
Fax: (607) 266-7341
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 216716 | New York |
Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases | 2080P0208X | 216716 | New York |
Profile Details
NPI number | 1124000518 |
---|---|
LBN Legal business name | Bradshaw, John Andrew |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 19th, 2005 |
Last updated | Sep 21st, 2012 - about 12 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 | 1124000518 | NPPES |
New York | Other | 10867 | TOTALCARE/MANAGED MA |
New York | Other | 000136319 | TOTALCARE/MANAGED MA |
New York | MEDICAID | 02223650 | TOTALCARE/MANAGED MA |
New York | Other | 00920290002 | TOTALCARE/MANAGED MA |
New York | Other | V018315 | TOTALCARE/MANAGED MA |
New York | Other | 161010811 | TOTALCARE/MANAGED MA |
New York | Other | 161010811 | TOTALCARE/MANAGED MA |
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