Individual
MR. IOSIF BADALOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
197 HALF HOLLOW RD, DIX HILLS, NY 11746-5861
(631) 370-1694
Mailing address
197 HALF HOLLOW RD, DIX HILLS, NY 11746-5859
(631) 370-1694
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
603369
NY
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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