Provider Demographics
NPI:1871038976
Name:BHADMUS, HADIJAT (LPN)
Entity Type:Individual
Prefix:
First Name:HADIJAT
Middle Name:
Last Name:BHADMUS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 ARLO RD APT 2B
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-4711
Mailing Address - Country:US
Mailing Address - Phone:929-200-0567
Mailing Address - Fax:
Practice Address - Street 1:34 ARLO RD APT 2B
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-4711
Practice Address - Country:US
Practice Address - Phone:929-200-0567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32609164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse