Individual
BADRI NATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4 PHYLLIS DRIVE, PATCHOGUE, NY 11772
(631) 289-4700
(631) 289-4718
Mailing address
4 PHYLLIS DRIVE, PATCHOGUE, NY 11772
(631) 289-4700
(631) 289-4718
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
194796
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01762005
—
NY
01
—
020038452
RR MCR
NY
01
—
2400686
GHI
NY
01
—
4635221
CIGNA
NY
01
—
P773785
OXF
NY
Enumeration date
02/14/2007
Last updated
01/20/2011
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