Individual
MR. JOHN BADESSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
100 KIMBERLY LN, WEST WARWICK, RI 02893-7420
(401) 489-4356
Mailing address
100 KIMBERLY LN, WEST WARWICK, RI 02893-7420
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OTA00238-G
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA00238-G
COTA
RI
Enumeration date
06/05/2013
Last updated
06/05/2013
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