Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 1619 | OH |
NPI | 1073607339 |
---|---|
Provider Name | Anthony J Badalamenti |
First Address | Aurora, OH 44202-8702 |
Second Address | Aurora, OH 44202-8702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 05/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0842735 | (05) | OH |
U22687 | (02) | OH |