MR. BRENDAN BRADFORD (NPI# 1346779139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346779139 |
| Entity Type | Individual |
| Full Name | MR. BRENDAN BRADFORD |
| Credential | PA-C |
| Practice Address |
1412 Fairmount Ave Philadelphia PA 19130-2908 |
| Mailing Address |
265 W Mount Pleasant Ave Apt C10 Philadelphia PA 19119-2448 |
| Practice Telephone | 2152359600 |
| Mailing Telephone | 5704069695 |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 120 S 30th St, Philadelphia, PA 191043403 | 2152222466 | |
| 1401 Dekalb St, Norristown, PA 194013405 | 6102787787 | |
| 401 W Allegheny Ave, Philadelphia, PA 191333644 | 2152912500 | |
| 800 Chester Pike, Sharon Hill, PA 190791400 | 6105371765 | |
| 801 W Girard Ave, Philadelphia, PA 191224212 | 2157872000 | |
| 841 E Hunting Park Ave, Philadelphia, PA 191244800 | 2155377695 |
| Street Address |
1412 FAIRMOUNT AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19130-2908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083616882 | Alvan Scott Mcneal | Family Medicine | 1412 Fairmount Ave, Philadelphia, PA 19130-2908 | 2005-08-11 |
| 1538772058 | Lindsay Reid | Physician Assistant | 1412 Fairmount Ave, Philadelphia, PA 19130-2908 | 2020-08-25 |
| 1518577188 | Alicia M Rivera Jones | Social Worker | 1412 Fairmount Ave, Philadelphia, PA 19130-2908 | 2020-08-07 |
| 1174183420 | Kimberly Yulick | Physician Assistant | 1412 Fairmount Ave, Philadelphia, PA 19130-2908 | 2019-06-18 |
| 1871068684 | Lorna L Okletey | Physician Assistant | 1412 Fairmount Ave, Philadelphia, PA 19130-2908 | 2018-10-08 |
| 1245729854 | Yamile Cuevas | Nurse Practitioner | 1412 Fairmount Ave, Philadelphia, PA 19130 | 2018-05-09 |
| 1508377060 | Amanda Sue Davis | Physician Assistant | 1412 Fairmount Ave, Philadelphia, PA 19130-2908 | 2017-10-23 |
| 1720508369 | Nikhil Abreo | Dentist | 1412 Fairmount Ave, Philadelphia, PA 19130-2908 | 2017-06-25 |
| 1770025033 | Tosha Lee | Registered Nurse | 1412 Fairmount Ave, Philadelphia, PA 19130-2908 | 2016-11-17 |
| 1518417955 | Tyler Cox | Physician Assistant | 1412 Fairmount Ave, Philadelphia, PA 19130-2908 | 2016-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912518226 | Karen Dybner-madero | Psychologist | 2201 Pennsylvania Avenue, The Parkway House, Suite 101, Philadelphia, PA 19130 | 2020-08-11 |
| 1689213456 | Nora Marie Corbett | Physical Therapist | 1714 Fairmount Avenue, Philadelphia, PA 19130 | 2019-12-27 |
| 1104470665 | Thibault Counseling LLC | Clinic/Center | 2049 North Street, Philadelphia, PA 19130 | 2019-08-01 |
| 1619444577 | Rebecca Boova | Dietitian, Registered | 1644 Francis St, #3, Philadelphia, PA 19130 | 2018-10-30 |
| 1184191108 | Sharon Marie Thompson | Nurse Practitioner | School District of Philadelphia/school Health Services, 440 North Broad Street, Philadelphia, PA 19130 | 2018-10-29 |
| 1861918542 | Theresa Mary Thompson | Dental Hygienist | Delaware Valley Community Health, 1412 Fairmount Avenue, Philadelphia, PA 19130 | 2017-08-15 |
| 1023539806 | Marina France | Social Worker | 2401 Pennsylvania Ave Ste 1a2, Philadelphia, PA 19130 | 2017-06-30 |
| 1619425063 | Sarah Nash | Dietitian, Registered | 420 North 20th Street, Philadelphia, PA 19130 | 2016-09-14 |
| 1154737757 | Julia Ferrence | Social Worker | 2305 Fairmount Avenue, Philadelphia, PA 19130 | 2014-07-03 |
| 1811319924 | Larry H Goldberg | Internal Medicine | 2441 Olive Street, Philadelphia, PA 19130 | 2014-01-08 |
| Find all providers in zip 19130 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051763 | Molly Catherine Peters | Physician Assistant | 4338 Boone St, Philadelphia, PA 19128-4901 | 2020-10-19 |
| 1356951024 | Murielle M Boursiquot | Physician Assistant | 7901 Henry Ave Apt G302, Philadelphia, PA 19128-3072 | 2020-08-06 |
| 1134757156 | Julie Hutchison | Physician Assistant | 2922 N 5th St, Philadelphia, PA 19133-2801 | 2020-03-27 |
| 1174155857 | Rebecca Volpe | Physician Assistant | 738 Longshore Ave, Philadelphia, PA 19111-4325 | 2020-02-10 |
| 1306308879 | Ria Raju | Physician Assistant | 7909 Lawndale Ave, Philadelphia, PA 19111-2652 | 2019-04-03 |
| 1386101400 | Ashley Thomas | Physician Assistant | 9331 Old Bustleton Ave Ste 100a, Philadelphia, PA 19115 | 2019-02-25 |
| 1487119186 | Shelby Elizabeth Ginsburg | Physician Assistant | 1200 W Tabor Rd Fl Bl4, Philadelphia, PA 19141-3019 | 2019-02-06 |
| 1346720059 | Noelle Elizabeth Mullanaphy | Physician Assistant | 4031 Sheffield St, Philadelphia, PA 19136-3101 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| 1912409533 | Lauren Joy Barton | Physician Assistant | 5401 N Broad St Ste 363, Philadelphia, PA 19141 | 2018-02-28 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19130 |
Please comment or provide details below to improve the information on MR. BRENDAN BRADFORD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.