Smith, Bradley J

Smith, Bradley J is an individual health care provider with primary practice located at 646 Kings Highway , West Deptford NJ 08096. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Smith, Bradley J can be contacted via phone (856) 879-2887.

Contact Information

Primary practice address
646 Kings Highway West Deptford NJ 08096
Phone: (856) 879-2887
Fax: (856) 879-2855
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25MA07583100 New Jersey
Allopathic & Osteopathic Physicians / Pediatrics 208000000X C10006619 Delaware

Profile Details

NPI number 1104874528
LBN Legal business name Smith, Bradley J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Apr 8th, 2009 - about 15 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 1104874528 NPPES
New Jersey MEDICAID 0030104
New Jersey MEDICAID 101123680
New Jersey MEDICAID 404782600

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