Provider Demographics
NPI:1811244205
Name:RIDGEFIELD MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:RIDGEFIELD MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BADRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-295-1616
Mailing Address - Street 1:8915 BERGENWOOD AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5349
Mailing Address - Country:US
Mailing Address - Phone:201-295-1616
Mailing Address - Fax:201-295-0032
Practice Address - Street 1:8915 BERGENWOOD AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5349
Practice Address - Country:US
Practice Address - Phone:201-295-1616
Practice Address - Fax:201-295-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA06158700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7100108Medicaid
NJG28518Medicare UPIN
NJ7100108Medicaid