Provider Demographics
NPI:1972315927
Name:RYAN BADOLATO, MD PLLC
Entity type:Organization
Organization Name:RYAN BADOLATO, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BADOLATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-535-8776
Mailing Address - Street 1:353 LEXINGTON AVE STE 314
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0941
Mailing Address - Country:US
Mailing Address - Phone:646-535-8776
Mailing Address - Fax:
Practice Address - Street 1:353 LEXINGTON AVE STE 314
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0941
Practice Address - Country:US
Practice Address - Phone:646-535-8776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty