Healthcare Provider Details

I. General information

NPI: 1932462140
Provider Name (Legal Business Name): MUSTANSER MAHMOOD BADAR MD, MPH, RPVI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SOUTHWOODS BLVD
ALBANY NY
12211-2514
US

IV. Provider business mailing address

7 SOUTHWOODS BLVD
ALBANY NY
12211-2514
US

V. Phone/Fax

Practice location:
  • Phone: 518-292-6000
  • Fax:
Mailing address:
  • Phone: 518-292-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number281990
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberV7818
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberV7818
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.129000
License Number StateOH
# 6
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number281990
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: