Provider Demographics
NPI:1881769412
Name:BRADY, ANN (NP)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:
Last Name:BRADY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 987
Mailing Address - Street 2:21 ORCHARD STREET
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940
Mailing Address - Country:US
Mailing Address - Phone:845-343-7614
Mailing Address - Fax:845-343-5390
Practice Address - Street 1:10 BENTON AVENUE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940
Practice Address - Country:US
Practice Address - Phone:845-343-8838
Practice Address - Fax:845-343-5390
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420109207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00355931Medicaid
NY331886Medicare Oscar/Certification