| Doctor Name: | DAN BRADY |
| NPI Number: | 1457749863 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 603929-1 |
| Business Practice Address: | 101 Downing Ave Sea Cliff, NY - 115792055 |
| Business Phone Number: | 5166711111 |
| Business Fax Number: | |
| Mailing Address: | 16 Crescent Beach Rd, GLEN COVE |
| State: | NY |
| Postal Code: | 115421836 |
| Phone Number: | 5166402231 |
| Fax Number: | |
| NPI Enumeration Date: | 01/07/2015 |
| NPI Last Update Date: | 01/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 603929-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |