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Provider Information for 1992893127


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Dr. BRADLEY ARDEN RADWANER M.D


Sex: Male

NPI: 1992893127
Last Updated: 2014-10-23
Certification Date:

Details

NameValue
NPI1992893127
Enumeration Date2006-10-11
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 136 E. 57TH ST.
SUITE 1001
NEW YORK, NY 10022
United States

Phone: 212-717-0666 | Fax:212-717-2399
 
Primary Practice Address 136 E. 57TH ST.
SUITE 1001
NEW YORK, NY 10022
United States

Phone: 212-717-0666 | Fax:212-717-2399
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNY00896117
Other (non-Medicare)NYBR078A9110BCBS
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 207RC0000X - Internal Medicine - Cardiovascular DiseaseNY150577