Provider Demographics
NPI:1710983010
Name:BRADY, JAMES W (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:BRADY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2451 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-1607
Mailing Address - Country:US
Mailing Address - Phone:516-766-2255
Mailing Address - Fax:212-879-8759
Practice Address - Street 1:519 E 72ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4028
Practice Address - Country:US
Practice Address - Phone:212-288-1575
Practice Address - Fax:212-288-7616
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1398632085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC05552Medicare UPIN
NY11D981Medicare ID - Type Unspecified