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General NPI Number Information
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NPI Number | 1275862591
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Entity Type | Organization
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Legal Business Name | BROOKLYN HEM-ONC MEDICAL, PLLC
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Dates
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Enumeration Date | 12/16/2009
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Last Update Date | 12/16/2009
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Provider Practice Location Address
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Address Line | 263 7TH AVE STE 4-G
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City | BROOKLYN
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State | NY
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Zip | 11215-3689
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Country | US
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Telephone | 718-499-9020
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Fax | 718-499-9021
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Provider Business Mailing Address
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Address Line | 263 7TH AVE STE 4-G
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City | BROOKLYN
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State | NY
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Zip | 11215-3689
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Country | US
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Telephone | 718-499-9020
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Fax | 718-499-9021
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Authorized Official
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Title or Position | OWNER
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Name | ADOLFO BADILLO
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Credential | MD
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Telephone | 718-499-9020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 204774
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License Number State | NY
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