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Individual

JOSEPH P BADOLATO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1818 E PASSYUNK AVE, PHILADELPHIA, PA 19148-2128
(215) 468-2553
Mailing address
1818 E PASSYUNK AVE, PHILADELPHIA, PA 19148-2128
(215) 468-2553

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0S005061L
PA
207Q00000X
Family Medicine Physician
25MB04305300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000124127
HIGHMARK BS
PA
01
0058472000
INDEPENDENCE BC
PA
01
232251238 00001
CIGNA
PA
01
4474097
AETNA
PA
05
6077609
NJ
01
A24127
AMERIHEALTH ADMINISTRATORS
PA
Enumeration date
12/08/2006
Last updated
09/03/2019
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