Liva, Bradford C

Liva, Bradford C is an sole proprietor health care provider with primary practice located at 119 Prospect St Ste 1 , Ridgewood NJ 07450-4451. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Liva, Bradford C can be contacted via phone (201) 444-1185.

Contact Information

Primary practice address
119 Prospect St Ste 1 Ridgewood NJ 07450-4451
Fax: (201) 444-1403
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MA38479 New Jersey
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 38479 New Jersey

Profile Details

NPI number 1669477485
LBN Legal business name Liva, Bradford C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 17th, 2005
Last updated Oct 15th, 2018 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669477485 NPPES
New Jersey MEDICAID 1389301

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