Healthcare Provider Details

I. General information

NPI: 1700298064
Provider Name (Legal Business Name): NABEEL JABBAR BADRI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 07/03/2023
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-2709
US

IV. Provider business mailing address

601 ELMWOOD AVE
ROCHESTER NY
14642-2709
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-5863
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number302403
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number302403
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: