Provider Demographics
NPI:1174927925
Name:SCHLUSSEL, BRADLEY (MD)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:
Last Name:SCHLUSSEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 W PARK AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-3129
Mailing Address - Country:US
Mailing Address - Phone:516-313-7248
Mailing Address - Fax:
Practice Address - Street 1:424 W PARK AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-3129
Practice Address - Country:US
Practice Address - Phone:516-313-7248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP04128207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty