Provider Demographics
NPI:1073607339
Name:BADALAMENTI, ANTHONY J (DC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:BADALAMENTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 N CHILLICOTHE RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-8702
Mailing Address - Country:US
Mailing Address - Phone:330-562-3142
Mailing Address - Fax:330-995-0230
Practice Address - Street 1:45 N CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-8702
Practice Address - Country:US
Practice Address - Phone:330-562-3142
Practice Address - Fax:330-995-0230
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1619111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0842735Medicaid
OH0842735Medicaid
OH0690962Medicare PIN