Provider Demographics
NPI:1154818201
Name:BADDAY, JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:BADDAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 MADISON AVE RM 407
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6438
Mailing Address - Country:US
Mailing Address - Phone:917-524-7246
Mailing Address - Fax:718-509-6961
Practice Address - Street 1:295 MADISON AVE RM 407
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6438
Practice Address - Country:US
Practice Address - Phone:917-524-7246
Practice Address - Fax:718-509-6961
Is Sole Proprietor?:No
Enumeration Date:2018-04-15
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1738972081P2900X
390200000X
NY314569-012081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program