Provider Demographics
NPI:1023883055
Name:BADAL, CHRISTINA MARY (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARY
Last Name:BADAL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 9TH ST APT 124
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-4201
Mailing Address - Country:US
Mailing Address - Phone:661-670-6043
Mailing Address - Fax:
Practice Address - Street 1:63 1/2 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2975
Practice Address - Country:US
Practice Address - Phone:781-842-3961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty