Provider Demographics
NPI:1205091477
Name:BADIA, GEORGE HENRY JR (RPH,)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:HENRY
Last Name:BADIA
Suffix:JR
Gender:M
Credentials:RPH,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 BUSSING AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2137
Mailing Address - Country:US
Mailing Address - Phone:201-233-1794
Mailing Address - Fax:
Practice Address - Street 1:3481 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-5612
Practice Address - Country:US
Practice Address - Phone:212-281-9410
Practice Address - Fax:212-281-9282
Is Sole Proprietor?:No
Enumeration Date:2008-07-27
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27368183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist