CHARLES B BRADSHAW PH.D NPI 1780632851

NPI Information

  • NPI: 1780632851
  • Provider Name: CHARLES B BRADSHAW, PH.D
  • Classification: Clinical Neuropsychologist - 103G00000X
  • Entity Type: Individual
  • Address: 750 E ADAMS ST
    DEPARTMENT OF NEUROLOGY
    SYRACUSE, NY
    ZIP 13210
  • Phone: (315) 464-5016

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NPI Details

Charles B Bradshaw, PH.D is a clinical neuropsychologist in Syracuse, NY. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. Charles B Bradshaw, PH.D NPI is 1780632851. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

750 E ADAMS ST
DEPARTMENT OF NEUROLOGY
SYRACUSE, NY
ZIP 13210-306
Phone: (315) 464-5016
Fax: (315) 464-5355

The enumeration date for this NPI number is 5/4/2006 and was last updated on 1/23/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103G00000XClinical Neuropsychologist010159NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
135124TMEDICARE PINNEW YORK
2R82316MEDICARE UPIN
301207905MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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