| Howard Bradnock Md Pc | |
|
19616 Hillside Ave Hollis NY 11423-2125 | |
| (718) 217-6806 | |
| (718) 217-0339 |
| Full Name | Howard Bradnock Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 19616 Hillside Ave, Hollis, New York |
| Authorized Official Name and Position | Howard W Bradnock (PRESIDENT) |
| Authorized Official Contact | 7182176806 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Howard Bradnock Md Pc 19616 Hillside Ave Hollis NY 11423-2125 Ph: (718) 217-6806 | Howard Bradnock Md Pc 19616 Hillside Ave Hollis NY 11423-2125 Ph: (718) 217-6806 |
| NPI Number | 1376712356 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 06/10/2020 |
| Medicare PECOS PAC ID | 9830080860 |
|---|---|
| Medicare Enrollment ID | O20080618000130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376712356 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 181072 (New York) | Primary |
| Provider Name | Howard W Bradnock |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225002751 PECOS PAC ID: 6709817745 Enrollment ID: I20050829001096 |
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