Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD424623 | PA |
Y | 208600000X | Surgeon | MD424623 | PA |
NPI | 1003052614 |
---|---|
Provider Name | Dr. Andrea Badillo |
First Address | Washington, DC 20010 |
Second Address | Washington, DC 20010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2009 |
Last Update Date | 23/06/2020 |