Badalov, Ilya
Badalov, Ilya is an individual health care provider with primary practice located at 14015 Sanford Ave , Flushing NY 11355-2686. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Badalov, Ilya can be contacted via phone (718) 670-6400.Contact Information
Primary practice address
14015 Sanford Ave
Flushing NY 11355-2686
Phone: (718) 670-6400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 214438 | New York |
Profile Details
| NPI number | 1679543888 |
|---|---|
| LBN Legal business name | Badalov, Ilya |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2006 |
| Last updated | Sep 9th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679543888 | NPPES |
| New York | MEDICAID | 02288737 |
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