Provider Demographics
NPI:1881289791
Name:RHATIGAN, BRADLEY JOSEPH (ARNP)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:JOSEPH
Last Name:RHATIGAN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 STIRLING RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1522
Mailing Address - Country:US
Mailing Address - Phone:954-357-0889
Mailing Address - Fax:
Practice Address - Street 1:85 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-1803
Practice Address - Country:US
Practice Address - Phone:860-224-3642
Practice Address - Fax:860-224-2760
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011798363L00000X, 363LF0000X
CT12659363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner