Healthcare Provider Details

I. General information

NPI: 1588300669
Provider Name (Legal Business Name): JOY SAMI BADAOUI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E ADAMS ST
SYRACUSE NY
13210-2306
US

IV. Provider business mailing address

750 E ADAMS ST
SYRACUSE NY
13210-2306
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-5240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberA205496
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: