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General NPI Number Information
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NPI Number | 1790004570
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Entity Type | Organization
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Legal Business Name | JEFFREY C. BADO, D.O., PC
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 05/19/2010
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Provider Practice Location Address
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Address Line | 5735 RIDGE AVE SUITE 104
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City | PHILADELPHIA
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State | PA
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Zip | 19128-1745
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Country | US
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Telephone | 215-483-6182
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Fax | 215-483-6186
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Provider Business Mailing Address
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Address Line | 5735 RIDGE AVE SUITE 104
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City | PHILADELPHIA
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State | PA
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Zip | 19128-1745
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Country | US
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Telephone | 215-483-6182
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Fax | 215-483-6186
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. STACEY VEERARAJ
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Credential |
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Telephone | 215-483-6182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS-005534L
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License Number State | PA
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