Smith, Bradley Glenn

Smith, Bradley Glenn is an individual health care provider with primary practice located at 100 Park St Glens Falls Hospital, Glens Falls NY 12801-4413. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Smith, Bradley Glenn can be contacted via phone (518) 926-5918.

Contact Information

Primary practice address
100 Park St Glens Falls Hospital Glens Falls NY 12801-4413
Phone: (518) 926-5918
Fax: (518) 926-5917
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 004333 New York

Profile Details

NPI number 1427039635
LBN Legal business name Smith, Bradley Glenn
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2005
Last updated Jun 17th, 2021 - about 3 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 1427039635 NPPES
New York Other P00180979 RR MEDICARE
New York MEDICAID 01893645 RR MEDICARE

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