Provider Demographics
NPI:1932360773
Name:ERTEL, BRADLEY R (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:R
Last Name:ERTEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3669 SOUTHWESTERN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1732
Mailing Address - Country:US
Mailing Address - Phone:716-491-0271
Mailing Address - Fax:
Practice Address - Street 1:3669 SOUTHWESTERN BLVD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1732
Practice Address - Country:US
Practice Address - Phone:716-828-2330
Practice Address - Fax:716-828-2955
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2020-09-08
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Provider Licenses
StateLicense IDTaxonomies
NY263500208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation