Gennel Tanisha Bradley, MS ED

NPI #1912409608 in Freeport, New York

Provider Information

NPI Number: 1912409608
Entity Type: Individual
Name: Gennel Tanisha Bradley, MS ED
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: MS ED
Enumeration Date: Mar 8, 2018
Last Updated: Mar 8, 2018

Practice Location

Address: 8 WILSHIRE CT
City: Freeport
State: New York
ZIP Code: 11520-6233
Phone: (516) 749-3851

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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