Provider Demographics
NPI:1114649167
Name:SCHMIDT, BRADLEY MICHAEL (APN)
Entity Type:Individual
Prefix:MR
First Name:BRADLEY
Middle Name:MICHAEL
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 ROUTE 73 N STE 320
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3426
Mailing Address - Country:US
Mailing Address - Phone:908-879-4300
Mailing Address - Fax:
Practice Address - Street 1:530 MAIN ST STE 4A
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2669
Practice Address - Country:US
Practice Address - Phone:908-879-4300
Practice Address - Fax:908-879-8956
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR17524200163W00000X
NJ26NJ01405300363LF0000X
NJ1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner