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NPI Code Detail

MEDICARE: JOSEPH P BADOLATO D.O.

MEDICARE:   JOSEPH P BADOLATO  D.O.
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
1207Q00000XFamily Medicine Physician25MB04305300NJ
2207Q00000XFamily Medicine Physician0S005061LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10058472000OTHERPAINDEPENDENCE BC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000124127OTHERPAHIGHMARK BS
4232251238 00001OTHERPACIGNA
54474097OTHERPAAETNA
6A24127OTHERPAAMERIHEALTH ADMINISTRATORS

General Provider Information

NPI Number : 1235298662
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH P BADOLATO D.O.
Provider Business Mailing Address
First Line : 1818 E PASSYUNK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19148-2128
Country : US
Telephone Number : 215-468-2553
Fax Number :
Provider Business Practice Location Address
First Line : 1818 E PASSYUNK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19148-2128
Country : US
Telephone Number : 215-468-2553
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 09/03/2019

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Directions to “ JOSEPH P BADOLATO D.O.” Practice Location

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