Provider Demographics
NPI:1164975447
Name:BIDABADI PEDIATRICS, LLC
Entity Type:Organization
Organization Name:BIDABADI PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBAK
Authorized Official - Middle Name:
Authorized Official - Last Name:BIDABADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-420-8150
Mailing Address - Street 1:3086 STATE ROUTE 27
Mailing Address - Street 2:SUITE 8
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1658
Mailing Address - Country:US
Mailing Address - Phone:732-422-0393
Mailing Address - Fax:732-821-0903
Practice Address - Street 1:3086 STATE ROUTE 27
Practice Address - Street 2:SUITE 8
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824-1658
Practice Address - Country:US
Practice Address - Phone:732-422-0393
Practice Address - Fax:732-821-0903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07775700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty