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Organization
MIND BODY MEDICAL SERVICES, PC
Active
Organization
MIND BODY MEDICAL SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL BAGGEROER MD (OWNER)
(603) 793-9263
Entity
Organization
Contact information
Practice address
1136 5TH AVE APT 7B, NEW YORK, NY 10128-0122
(202) 327-3100
Mailing address
1136 5TH AVE APT 7B, NEW YORK, NY 10128-0122
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
07/15/2022
Last updated
03/12/2024
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