CHARLES B BRADSHAW


Address: 750 E Adams St, Department of Neurology, Syracuse, NY 13210-2306
Phone: 3154645016

CHARLES B BRADSHAW (NPI# 1780632851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1780632851
Entity Type Individual
Full Name CHARLES B BRADSHAW
Credential PH.D
Practice Address 750 E Adams St
Department of Neurology
Syracuse
NY 13210-2306
Mailing Address 750 E Adams St
Syracuse
NY 13210-2306
Practice Telephone 3154645016
Practice Fax Number 3154645355
Mailing Telephone 3154645016
Mailing Fax Number 3154647328
Enumeration Date 2006-05-04
Last Update Date 2009-01-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist 010159 NY Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NY 01207905 05

Other Providers CHARLES BRADSHAW

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1538361456 Charles Pedigo Bradshaw Dentist 220 Conway St, Suite 2, Frankfort, KY 40601-2748 2007-06-04
1104866714 Charles Marshall Bradshaw Specialist 1521 Cooper St, Fort Worth, TX 76104-2711 2006-06-08

Office Location

Street Address 750 E ADAMS ST
DEPARTMENT OF NEUROLOGY
City SYRACUSE
State NY
Zip Code 13210-2306

Providers in the same location

NPI Name Taxonomy Address Enumeration
1922003193 Aqeel A Sandhu Specialist 750 E Adams St, Syracuse, NY 13210-2306 2005-06-15
1770183972 Subhashree Dasgupta Speech-Language Pathologist 750 E Adams St, Syracuse, NY 13210-1834 2020-10-27
1841890118 Danielle Coniglio Gonzalez Physical Medicine & Rehabilitation 750 E Adams St, Syracuse, NY 13210-2306 2020-10-27
1497353858 Kayleigh M Gifford Nurse Practitioner 750 E Adams St, Syracuse, NY 13210-1834 2020-10-16
1578160891 Steven Lounsbury Physical Therapist 750 E Adams St, Syracuse, NY 13210-2306 2020-10-09
1306453295 Sarah Persons Nurse Practitioner 750 E Adams St, Syracuse, NY 13210-1834 2020-09-25
1356956270 Carlo Manalo Dangcalan Student in an Organized Health Care Education/Training Program 750 E Adams St, Syracuse, NY 13210-2306 2020-09-09
1104430396 Rida Sherwani Student in an Organized Health Care Education/Training Program 750 E Adams St, Syracuse, NY 13210-2306 2020-09-03
1003420803 Michel Tawil Student in an Organized Health Care Education/Training Program 750 E Adams St, Syracuse, NY 13210-2306 2020-08-31
1669085056 Komal Syeda Nurse Practitioner 750 E Adams St, Syracuse, NY 13210-1834 2020-08-26
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1558973586 Maizie Marie Shaw Social Worker 660 Madison Street, Syracuse, NY 13210 2020-08-20
1427666916 Christine Marie Welker Registered Nurse 735 Irving Avenue, Syracuse, NY 13210 2020-07-21
1386263994 Ashwini Krishna Ashwath Student in an Organized Health Care Education/Training Program 750 E. Adams Street, Syracuse, Ny 13210, Syracuse, NY 13210 2020-04-14
1073142329 Kamala Ojha Student in an Organized Health Care Education/Training Program 750-east Adam's Street, Syracuse, NY 13210 2020-04-07
1003442369 Brittany Nicole Lippert Counselor 615 Madison St, Syracuse, NY 13210 2020-03-19
1902430499 Dkt Physician Pllc Internal Medicine 475 Irving Ave, Suite 410, Syracuse, NY 13210 2020-02-24
1376194720 Sarah Van Eenenaam Physician Assistant Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 2019-09-26
1265099022 Michelle Gallagher Psychologist Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210 2019-05-28
1639659428 Francesca Wanda Cotrupe Physical Medicine & Rehabilitation Upstate Medical University Hospital, 750 E Adams Street, Syracuse, NY 13210 2018-08-21
1700370327 Dallin Lindahl Physical Medicine & Rehabilitation 750 E Adams St # Jh308, Syracuse, NY 13210 2018-06-18
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1225355456 Lauren Half Warren-faricy Clinical Neuropsychologist 505 Irving Ave Ste 1249, Institute for Human Performance, Syracuse, NY 13210-1718 2010-04-28
1841674553 Rebecca Gavett Clinical Neuropsychologist 505 Irving Ave, Suny Upstate Medical University, Syracuse, NY 13210-1718 2015-07-13
1689949836 Gila Z. Reckess Clinical Neuropsychologist 505 Irving Ave, Syracuse, NY 13210-1718 2012-03-20
1346379609 Allan Yozawitz Clinical Neuropsychologist 1101 Erie Blvd E, Suite 207, Syracuse, NY 13210-1144 2007-03-05
1902997588 Dominic A Carone Clinical Neuropsychologist 750 E Adams St, 2 North, Syracuse, NY 13210-2306 2006-09-27

Providers in the same taxonomy and state

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1720633860 Emily Kurlansik Clinical Neuropsychologist 300 W 55th St Apt 6c, New York, NY 10019-5164 2019-08-06
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1447729595 Beth Krone Clinical Neuropsychologist 6818 Bay Cliff Ter, Brooklyn, NY 11220-5114 2018-11-19
1750860144 Linda Cristina Calderon Clinical Neuropsychologist 635 W 165th St Rm 633a, New York, NY 10032-3724 2018-08-07
1366936585 Nicole Feirsen Clinical Neuropsychologist 3307 Bainbridge Ave Fl 1, Bronx, NY 10467-2850 2018-06-20
1306349493 Abhishek Jaywant Clinical Neuropsychologist 525 E 68th St # F-1699g, New York, NY 10065-4870 2018-03-14
1043718505 Elsa Lee Clinical Neuropsychologist 25418 Northern Blvd Ste 3, Little Neck, NY 11362-1451 2018-01-30
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Competitor

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City SYRACUSE
Zip Code 13210

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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