Provider Demographics
NPI:1275826554
Name:BADA, OLGA
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:BADA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E 33RD ST
Mailing Address - Street 2:10TH FLOOR BELLEVUE CLINIC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5334
Mailing Address - Country:US
Mailing Address - Phone:212-686-1520
Mailing Address - Fax:212-686-3603
Practice Address - Street 1:111 E 33RD ST
Practice Address - Street 2:10TH FLOOR BELLEVUE CLINIC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5334
Practice Address - Country:US
Practice Address - Phone:212-686-1520
Practice Address - Fax:212-686-3603
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082715104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker