Provider Demographics
NPI:1346053766
Name:BRADY, NYHEMIAH NICKESHA
Entity type:Individual
Prefix:
First Name:NYHEMIAH
Middle Name:NICKESHA
Last Name:BRADY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 PAERDEGAT 13TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4122
Mailing Address - Country:US
Mailing Address - Phone:201-951-3516
Mailing Address - Fax:
Practice Address - Street 1:28 PAERDEGAT 13TH ST FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4122
Practice Address - Country:US
Practice Address - Phone:201-951-3516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346195164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse