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NPI Code Detail

MEDICARE: MARY R BADO LCSWR

MEDICARE: MARY R BADO LCSWR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerR051626NY

General Provider Information

NPI Number : 1033163431
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY R BADO LCSWR
Provider Business Mailing Address
First Line : PO BOX 305
Second Line :
City : OWEGO
State : NY
Zip : 13827-0305
Country : US
Telephone Number : 607-733-5696
Fax Number : 607-737-1379
Provider Business Practice Location Address
First Line : 1019 E WATER ST
Second Line :
City : ELMIRA
State : NY
Zip : 14901-3332
Country : US
Telephone Number : 607-733-5696
Fax Number : 607-737-1379
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 07/08/2007

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Directions to “ MARY R BADO LCSWR” Practice Location

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