National Provider Identifier
Bertina Bradshaw
Bertina Bradshaw is listed in the NPPES registry with a primary specialty of Substance Use Disorder Rehabilitation Clinic/Center in Elmira, NY and a listed phone number of (607) 737-5215.
Profile Overview
- NPI
- 1043593809
- Provider Type
- Individual
- Primary Specialty
- Substance Use Disorder Rehabilitation Clinic/Center
- Enumeration Date
- September 27, 2011
- Last Updated
- September 27, 2011
Practice Location
- 571 St. Joseph'S Blvd.
- Suite 102
- Elmira, NY 14901-3230
Phone: (607) 737-5215
Specialties
- Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X)
Full Record
- NPI
- 1043593809
- Entity Type
- Individual
- Last Name
- Bradshaw
- First Name
- Bertina
- Mailing Street Address
- 571 St. Joseph'S Blvd.
- Mailing Address Line 2
- Suite 102
- Mailing City
- Elmira
- Mailing State
- NY
- Mailing ZIP Code
- 14901-3230
- Mailing Country
- US
- Practice Street Address
- 571 St. Joseph'S Blvd.
- Practice Address Line 2
- Suite 102
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14901-3230
- Practice Country
- US
- Practice Phone
- (607) 737-5215
- Enumeration Date
- September 27, 2011
- Last Updated
- September 27, 2011
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X)
- Other Identifiers
- 1023054376 (NY)