Provider Demographics
NPI:1215245295
Name:BADR, RAIF (RN)
Entity type:Individual
Prefix:
First Name:RAIF
Middle Name:
Last Name:BADR
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 ADAMSON ST
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-4403
Mailing Address - Country:US
Mailing Address - Phone:631-880-7616
Mailing Address - Fax:
Practice Address - Street 1:17 ADAMSON ST
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-4403
Practice Address - Country:US
Practice Address - Phone:631-880-7616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY495751-1163WC1500X, 163WD0400X, 163WE0900X, 163WG0000X, 163WP0000X, 163WW0000X, 163WX0800X
NYNONE332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic