Organization
ILYA BADALOV PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILYA BADALOV MD (PRESIDENT)
(718) 847-9329
Entity
Organization
Contact information
Practice address
13511 78TH DR, FLUSHING, NY 11367-3235
(718) 847-9329
Mailing address
13511 78TH DR, FLUSHING, NY 11367-3235
(718) 847-9329
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Enumeration date
10/31/2008
Last updated
10/31/2008
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