Nison L Badalov MD PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

242278 Issued in NY

Legal business name

NISON L BADALOV MD PC

Practice address

107-21 Queens Blvd
Suite 4
Forest Hills, NY 11375-4451

Phone

(718) 520-0857

Fax

(718) 520-9099

NPI assigned

Mar 26, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nison L. Badalov, MD

Title

Owner

Phone

(718) 520-0857

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1528485752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107-21 QUEENS BLVD",
            "address_2": "SUITE 4",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754451",
            "telephone_number": "718-520-0857",
            "fax_number": "718-520-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107-21 QUEENS BLVD",
            "address_2": "SUITE 4",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754451",
            "telephone_number": "718-520-0857",
            "fax_number": "718-520-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NISON L BADALOV MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "BADALOV",
        "authorized_official_first_name": "NISON",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-520-0857",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "242278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge David Nieves, M.D.
• Dvora L Nir, LMSW
• Ariela Nisanov
• Kcenia Nisanov
• Tami Nisanov
• Adella Niyazov, RN
• Galina Niyazov, O.D.
• Avital Niyazova, RN
• Sarah S Niyazova
• Susanna Niyazova, PHARM D.

• Gastroenterology Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.