Provider Demographics
NPI:1013014836
Name:BRADLOW, JONATHAN A (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:A
Last Name:BRADLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 GRAND CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-1247
Mailing Address - Country:US
Mailing Address - Phone:718-933-2244
Mailing Address - Fax:718-365-0657
Practice Address - Street 1:MMC- CARDIOLOGY ASSOCIATES
Practice Address - Street 2:3201 GRAND CONCOURSE, #1J
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468
Practice Address - Country:US
Practice Address - Phone:718-933-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193257207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease