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MR. GLEN DALE BRADY L.P.N
NPI 1063691533
Licensed Practical Nurse in Rochester, NY

Active since October 31, 2007
78 WILLMONT ST, ROCHESTER, NY 14609(585) 288-6598 Get Directions Write a Review

NPPES record last updated: October 31, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Glen Dale Brady L.p.n NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. GLEN DALE BRADY L.P.N (NPI 1063691533) is an individual licensed practical nurse in Rochester, New York, licensed in New York (231182-1) and active in the NPI registry since October 2007.

NPPES Registry Identity

NPI1063691533
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameMR. GLEN DALE BRADYCredential: L.P.N
Location Address78 WILLMONT STRochester, NY 14609-3620
Mailing Address78 Willmont StRochester, NY 14609-3620 · (585) 288-6598
Phone(585) 288-6598
Sole ProprietorYes
Enumeration DateOctober 31, 2007
✔ NPI 1063691533 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in NY · 231182-1
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
78 WILLMONT ST, Rochester, NY 14609
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Other Identifiers 1

Medicaid02206848NY

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glen Brady's NPI number?

The NPI number for Glen Brady is 1063691533. It was assigned to this individual provider in the NPPES registry on October 31, 2007.

Where is Glen Brady located?

Glen Brady practices at 78 Willmont St, Rochester, NY 14609. The listed phone number is (585) 288-6598.

What is Glen Brady's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Glen Brady was last updated on October 31, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.