Basic Information
| Provider Information | |||||||||
| NPI: | 1417301516 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BADILLO | ||||||||
| FirstName: | DANIEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 E CEDAR ST | ||||||||
| Address2: | GROUND FLOOR | ||||||||
| City: | MOUNT VERNON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105523006 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 481 MAIN ST | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | NEW ROCHELLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 108016324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143552440 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2016 | ||||||||
| LastUpdateDate: | 04/21/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 006910 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.