National Provider Identifier
Bradley Thomas Dewitt, PA-C
Bradley Thomas Dewitt, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Ithaca, NY and a listed phone number of (315) 283-3608.
Profile Overview
- NPI
- 1346891900
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- September 25, 2019
- Last Updated
- March 24, 2021
Practice Location
- 1780 Hanshaw RD
- Ithaca, NY 14850-9105
Phone: (315) 283-3608
Mailing Address
- 1 Guthrie Sq
- Sayre, PA 18840-1625
Specialties
- Physician Assistant (363A00000X)
Endpoints
- bdewitt147439@direct-guthrie.org
Direct Messaging Address | Direct | Ithaca, NY 14850
Full Record
- NPI
- 1346891900
- Entity Type
- Individual
- Last Name
- Dewitt
- First Name
- Bradley
- Middle Name
- Thomas
- Name Prefix
- Mr.
- Credential
- PA-C
- Mailing Street Address
- 1 Guthrie Sq
- Mailing City
- Sayre
- Mailing State
- PA
- Mailing ZIP Code
- 18840-1625
- Mailing Country
- US
- Mailing Phone
- (570) 888-5858
- Practice Street Address
- 1780 Hanshaw RD
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-9105
- Practice Country
- US
- Practice Phone
- (315) 283-3608
- Enumeration Date
- September 25, 2019
- Last Updated
- March 24, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- March 24, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)