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1457658791
BRADLEY P HEROLD
DERBY, CT
NPI
1457658791
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: CT 3050)
Enumeration Date
2011-02-23
Last Update Date
2018-10-12
Business Address
Mr. BRADLEY P HEROLD PA-C
130 DIVISION ST
DERBY, CT 06418-1326
Phone number: 203-735-7421
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Mailing Address
Mr. BRADLEY P HEROLD PA-C
67 MAPLE AVE
DERBY, CT 06418-1328
Phone number: 203-732-1330
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