Provider Demographics
NPI:1790569952
Name:BADLEY, DARRYL LENARD JR
Entity Type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:LENARD
Last Name:BADLEY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19351 PASNOW AVE
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44119-1468
Mailing Address - Country:US
Mailing Address - Phone:216-474-5747
Mailing Address - Fax:
Practice Address - Street 1:19351 PASNOW AVE
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-1468
Practice Address - Country:US
Practice Address - Phone:216-474-5747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care