Provider Demographics
NPI:1679541817
Name:BRADLEY, JOSEPH J (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:BRADLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:253 PLEASANT ST
Mailing Address - Street 2:RADIOLOGY
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-7560
Mailing Address - Country:US
Mailing Address - Phone:603-653-7650
Mailing Address - Fax:
Practice Address - Street 1:253 PLEASANT ST
Practice Address - Street 2:RADIOLOGY
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7560
Practice Address - Country:US
Practice Address - Phone:603-653-7650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA745282085R0202X
NH180982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2090677OtherFIRST HEALTH
470523OtherTUFTS HEALTH PLAN
57116OtherFALLON COMMUNITY HEALTH P
042472266OtherPRIVATE HEALTHCARE SYSTEM
784211OtherMVP HEALTH CARE
M02254OtherBLUE CARE ELECT
042472266OtherTRICARE CHAMPUS
042472266OtherTHREE RIVERS
7613577OtherAETNA US HEALTHCARE
AA5959OtherHARVARD PILGRIM
042472266OtherHEALTHCARE VALUE MANAGEME
MA2002451Medicaid
44839OtherCHILDRENS MEDICAL SECURIT
P00005834OtherRAILROAD MEDICARE
44839OtherHEALTHY START
7794897OtherCIGNA HEALTH PLAN
042472266OtherONE HEALTH PLAN
M02254OtherBLUE SHIELD HMO BLUE
AA5959OtherHARVARD PILGRIM
AA5959OtherHARVARD PILGRIM