Provider Demographics
NPI:1639597289
Name:BADAR, ZAIN (MD)
Entity Type:Individual
Prefix:
First Name:ZAIN
Middle Name:
Last Name:BADAR
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 1:883 STONEBRIDGE AVENUE
Mailing Address - Street 2:
Mailing Address - City:MISSISSAUGA
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L5V 2L3
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:33-57 HARRISON ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2107
Practice Address - Country:US
Practice Address - Phone:607-763-6674
Practice Address - Fax:607-798-1629
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-01
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-004342085R0204X
390200000X
CT675882085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program