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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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