Gluck, Bradley

Gluck, Bradley is an individual health care provider with primary practice located at 1333 Roanoke Ave , Riverhead NY 11901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Gluck, Bradley can be contacted via phone (631) 727-2755.

Contact Information

Primary practice address
1333 Roanoke Ave Riverhead NY 11901
Phone: (631) 727-2755
Fax: (631) 208-9521
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 175471 New York

Profile Details

NPI number 1982617684
LBN Legal business name Gluck, Bradley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated May 16th, 2008 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982617684 NPPES
New York Other CF3402 RR MEDICARE
New York Other W11401 RR MEDICARE
New York MEDICAID 01427123 RR MEDICARE
New York Other W22111 RR MEDICARE
New York Other WEU091 RR MEDICARE

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