Provider Demographics
NPI:1679615553
Name:BADAWY, BADAWY MOHAMED (MD)
Entity Type:Individual
Prefix:DR
First Name:BADAWY
Middle Name:MOHAMED
Last Name:BADAWY
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 1:2738 KENNEDY BLVD.
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306
Mailing Address - Country:US
Mailing Address - Phone:201-985-9000
Mailing Address - Fax:201-938-0666
Practice Address - Street 1:2738 KENNEDY BLVD.
Practice Address - Street 2:1ST FLOOR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5508
Practice Address - Country:US
Practice Address - Phone:201-985-9000
Practice Address - Fax:201-938-0666
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ64724146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7028202Medicaid
NJG38925Medicare ID - Type UnspecifiedM.D.
NJ7028202Medicaid