Fadi Badlissi
Rheumatology Geriatric Medicine
545a Centre St
Jamaica Plain
, Massachusetts 02130-2061
Fadi Badlissi
Rheumatology Geriatric Medicine
545a Centre St
Jamaica Plain
, Massachusetts 02130-2061
(617) 524-2966
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About
Features
Specialties
- Geriatric Medicine
- Rheumatology
Languages spoken
- English
Location
First Address
- Fadi Badlissi
- 545a Centre St Urban Medical Group,
- Jamaica Plain, MA
- Zip : 02130-2061
- Fax : (617) 524-2966
- Phone : (617) 522-5464
Second Address
- Fadi Badlissi
- 545a Centre St
- Jamaica Plain, MA
- Zip : 02130-2061
- Fax : (617) 524-2966
- Phone : (617) 522-5464
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207RG0300X | Geriatric Medicine | 158553 | MA |
| Y | 207RR0500X | Rheumatology | 158553 | MA |
National Provider Identifier
| NPI | 1134118714 |
|---|---|
| Provider Name | Fadi Badlissi |
| First Address | Jamaica Plain, MA 02130-2061 |
| Second Address | Jamaica Plain, MA 02130-2061 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/10/2005 |
| Last Update Date | 14/05/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 2024811 | (05) | MA |
| H92578 | (02) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.