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NPI Code Detail

MEDICARE: AHMED A BADAWY

MEDICARE: AHMED A BADAWY
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
11223G0001XGeneral Practice Dentistry054557-1NY

General Provider Information

NPI Number : 1851523120
Entity Type Code : Individual
Provider Name (Legal Business Name) : AHMED A BADAWY
Provider Business Mailing Address
First Line : PO BOX 3189
Second Line :
City : SYRACUSE
State : NY
Zip : 13220-3189
Country : US
Telephone Number : 315-445-6000
Fax Number :
Provider Business Practice Location Address
First Line : 124 NORTHERN LIGHTS DR
Second Line :
City : SYRACUSE
State : NY
Zip : 13212-4108
Country : US
Telephone Number : 315-455-2411
Fax Number : 315-455-1899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2009
Last Update Date : 08/19/2009

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1578780656 — ASPEN DENTAL OF CENTRAL NEW YORK
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1477889178 — ASPEN DENTAL OF CENTRAL NEW YORK, PLLC
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Directions to “ AHMED A BADAWY ” Practice Location

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