Healthcare Provider Details

I. General information

NPI: 1841399490
Provider Name (Legal Business Name): ROCIO E BADRA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 06/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BEECH DR
NORRISTOWN PA
19403-5421
US

IV. Provider business mailing address

50 BEECH DR
NORRISTOWN PA
19403-5421
US

V. Phone/Fax

Practice location:
  • Phone: 610-279-6100
  • Fax: 610-279-0978
Mailing address:
  • Phone: 610-279-6100
  • Fax: 610-279-0978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberMD035508L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD035508L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: