Basic Information
Provider Information
NPI: 1699092726
EntityType: 2
ReplacementNPI:  
OrganizationName: BAYADA HOME HEALTH CARE, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BAYADA PEDIATRICS
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4300 HADDONFIELD RD
Address2:  
City: PENNSAUKEN
State: NJ
PostalCode: 081093376
CountryCode: US
TelephoneNumber: 9739095159
FaxNumber:  
Practice Location
Address1: 100 N 20TH ST STE 201
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191031454
CountryCode: US
TelephoneNumber: 2159889006
FaxNumber: 2159889115
Other Information
ProviderEnumerationDate: 04/29/2010
LastUpdateDate: 05/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BAIADA
AuthorizedOfficialFirstName: DAVID
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT/CEO
AuthorizedOfficialTelephone: 8566624300
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: BAYADA HOME HEALTH CARE, INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/11/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X04940501PAY AgenciesHome Health 

No ID Information.


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