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Individual

JUAN BAILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
FIRST AVENUE AT 16TH STREET, NEW YORK, NY 10003-3314
(212) 420-3470
Mailing address
PO BOX 95000-2433, PHILADELPHIA, PA 19195-2433
(212) 420-3470

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
148053
NY
207RI0200X
Infectious Disease Physician
Primary
148053
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01495541
NY
Enumeration date
11/11/2005
Last updated
02/21/2019
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