MEDICARE: DR. MOHAMMAD BADDAD M.D.

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	2084N0008X	Neuromuscular Medicine (Psychiatry & Neurology) Physician	303864	NY
2	2084N0400X	Neurology Physician	303864	NY
3	2084N0400X	Neurology Physician	ME159011	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598110058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMMAD BADDAD M.D.

Provider Business Mailing Address
First Line	:	225 BROADWAY STE 705
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10007-3791
Country	:	US
Telephone Number	:	800-200-8196
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 CORAL SANDS DR STE B
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-2748
Country	:	US
Telephone Number	:	321-345-6331
Fax Number	:	321-345-3295

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

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	11/04/2022

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Directions to “ DR. MOHAMMAD BADDAD M.D.” Practice Location

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