Mariusz Badzio

Individual provider Active NPI Early Intervention Provider Agency · Glendale, NY

NPI 1801504147 · NPPES record last updated Nov 7, 2022

Key facts

NPI
1801504147
Entity type
Individual (NPI type 1)
Primary specialty
Early Intervention Provider Agency 252Y00000X
License
3077560 (NY)
Practice address
9050 Union Tpke Apt 17J
Glendale, NY 11385-8068
Phone
(718) 687-3370
NPI assigned
Nov 7, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3077560NYMDEarly Intervention Provider Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 3077560 NY Yes

Addresses

Primary practice location

9050 Union Tpke Apt 17J
Glendale, NY 11385-8068

Mailing address

9050 Union Tpke Apt 17J
Glendale, NY 11385-8068
Phone (718) 687-3370

Other providers in Glendale, NY

All providers in Glendale, NY · Early Intervention Provider Agency in New York

Sources for this page

Verify at the official NPI Registry.