Provider Demographics
NPI:1912086885
Name:BADGLEY, BARBARA KIM (NP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:KIM
Last Name:BADGLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4373 REITER RD
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-9584
Mailing Address - Country:US
Mailing Address - Phone:716-655-7583
Mailing Address - Fax:716-655-7583
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:BGH EMERGENCY DEPARTMENT
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-1993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33-332761363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily