Provider Demographics
NPI:1558410860
Name:BADO, ROBERT THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:THOMAS
Last Name:BADO
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 1:854 QUEEN ANNE RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4622
Mailing Address - Country:US
Mailing Address - Phone:201-692-9384
Mailing Address - Fax:201-836-8280
Practice Address - Street 1:854 QUEEN ANNE RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4622
Practice Address - Country:US
Practice Address - Phone:201-692-9384
Practice Address - Fax:201-836-8280
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00284500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0004229438OtherAETNA PIN
NJP471726OtherOXFORD PROVIDER ID
NJ475438OtherUHC MPIN
NJ0004229438OtherAETNA PIN