Provider Demographics
NPI:1396743829
Name:DELLA BADIA, JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:DELLA BADIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:2016 BRONXDALE AVE
Mailing Address - Street 2:HEALTHCARE RADIOLOGY
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457
Mailing Address - Country:US
Mailing Address - Phone:718-960-9033
Mailing Address - Fax:914-681-2906
Practice Address - Street 1:ST. BARNABAS HOSPITAL / RADIOLOGY DEPARTMENT
Practice Address - Street 2:4422 3RD AVE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457
Practice Address - Country:US
Practice Address - Phone:718-960-6162
Practice Address - Fax:718-960-3612
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1739692085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01133146Medicaid
NY17F021Medicare ID - Type Unspecified
E04044Medicare UPIN