Individual
RAIF BADR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
17 ADAMSON ST, SELDEN, NY 11784-4403
(631) 880-7616
Mailing address
17 ADAMSON ST, SELDEN, NY 11784-4403
(631) 880-7616
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
495751-1
NY
163WD0400X
Diabetes Educator Registered Nurse
495751-1
NY
163WE0900X
Enterostomal Therapy Registered Nurse
495751-1
NY
163WG0000X
General Practice Registered Nurse
495751-1
NY
163WP0000X
Pain Management Registered Nurse
495751-1
NY
163WW0000X
Wound Care Registered Nurse
495751-1
NY
163WX0800X
Orthopedic Registered Nurse
495751-1
NY
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
NONE
NY
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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