MEDICARE: RIDGEFIELD MEDICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MA61587	NJ

General Provider Information

NPI Number	:	1205960150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIDGEFIELD MEDICAL GROUP

Provider Business Mailing Address
First Line	:	8915 BERGENWOOD AVE
Second Line	:	SUITE # 3
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5349
Country	:	US
Telephone Number	:	201-295-1616
Fax Number	:	201-295-0032

Provider Business Practice Location Address
First Line	:	8915 BERGENWOOD AVE
Second Line	:	SUITE # 3
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5349
Country	:	US
Telephone Number	:	201-295-1616
Fax Number	:	201-295-0032

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MAHER A BADRI
Credential	:	MD
Telephone Number	:	201-295-1616

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	08/22/2020

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Directions to “RIDGEFIELD MEDICAL GROUP ” Practice Location

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