Individual provider · Type 1 NPI

Mary Theresa Bradshaw, NP

Family Nurse Practitioner · New York, NY

NPI number 1083290928 Active

Practice location

630 W 168th St
New York, NY 10032-3725

Specialties and licenses

Taxonomy	Code	License
Family Nurse Practitioner Primary	363LF0000X	F342967-1 (NY)

Family Nurse Practitioner: Definition to come...

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About NPI 1083290928

Mary Theresa Bradshaw, NP's National Provider Identifier is 1083290928, issued on Mar 22, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in New York, NY. The record was last updated on Mar 22, 2021.