Provider Demographics
NPI:1407958994
Name:TRUAX, BRADLEY THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:THOMAS
Last Name:TRUAX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 FORT GRAY DR
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092-1941
Mailing Address - Country:US
Mailing Address - Phone:716-285-4327
Mailing Address - Fax:716-285-4327
Practice Address - Street 1:471 FORT GRAY DR
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092-1941
Practice Address - Country:US
Practice Address - Phone:716-285-4327
Practice Address - Fax:716-285-4327
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1373722084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology