MEDICARE: DR. HARRY A BADE III MD

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
1	207X00000X	Orthopaedic Surgery Physician	MA41026	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200026580	OTHER	NJ	RR MEDICARE
9	CC3884	OTHER	NJ	RR MEDICARE GRP#

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	40354	OTHER	NJ	AETNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	J25332	OTHER	NJ	HEALTHNET
6	P2987248	OTHER	NJ	OXFORD
7	0328229	OTHER	NJ	UNITED HEALTHCARE
8	310173900	OTHER	NJ	US DEPT OF LABOR
10	917483	OTHER	NJ	PHS/GUARDIAN

General Provider Information

NPI Number	:	1508843624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY A BADE III MD

Provider Business Mailing Address
First Line	:	776 SHREWSBURY AVE
Second Line	:	SUITE 201
City	:	TINTON FALLS
State	:	NJ
Zip	:	07724-3006
Country	:	US
Telephone Number	:	732-530-4949
Fax Number	:	732-212-1171

Provider Business Practice Location Address
First Line	:	776 SHREWSBURY AVE
Second Line	:	SUITE 201
City	:	TINTON FALLS
State	:	NJ
Zip	:	07724-3006
Country	:	US
Telephone Number	:	732-530-4949
Fax Number	:	732-530-3618

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	03/13/2013

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