Provider Demographics
NPI:1588769467
Name:BRADMAN, JAMES ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:BRADMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1337
Mailing Address - Country:US
Mailing Address - Phone:585-343-6060
Mailing Address - Fax:585-344-8685
Practice Address - Street 1:352 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1337
Practice Address - Country:US
Practice Address - Phone:585-343-6060
Practice Address - Fax:585-344-8685
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005304111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT26047Medicare UPIN
NYJB064911Medicare ID - Type Unspecified