Provider Demographics
NPI:1891089165
Name:BRADY, CAROL (BC-HIS)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:BRADY
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LEE WAY
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2512
Mailing Address - Country:US
Mailing Address - Phone:732-387-2395
Mailing Address - Fax:908-575-8532
Practice Address - Street 1:10 AUER CT
Practice Address - Street 2:SUITE C
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5848
Practice Address - Country:US
Practice Address - Phone:732-387-2395
Practice Address - Fax:732-387-2394
Is Sole Proprietor?:No
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00069100237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist