Provider Demographics
NPI:1700318367
Name:BADRI, MALAKA (DO)
Entity Type:Individual
Prefix:
First Name:MALAKA
Middle Name:
Last Name:BADRI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:189 BERDAN AVE UNIT 169
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-3233
Mailing Address - Country:US
Mailing Address - Phone:973-363-2029
Mailing Address - Fax:973-363-3932
Practice Address - Street 1:7823 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4942
Practice Address - Country:US
Practice Address - Phone:973-363-2029
Practice Address - Fax:973-363-3932
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2022-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB11207400208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine