Provider Demographics
NPI:1952024184
Name:BRADY, TONY JOSEPH (PA)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:JOSEPH
Last Name:BRADY
Suffix:
Gender:M
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:50704 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-1273
Mailing Address - Country:US
Mailing Address - Phone:586-864-7088
Mailing Address - Fax:
Practice Address - Street 1:1701 SOUTH BLVD E STE 110
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-6118
Practice Address - Country:US
Practice Address - Phone:248-853-0803
Practice Address - Fax:248-852-5859
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant