Individual
LYDIA MINJUNG BAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
333 E 38TH ST FL 4, NEW YORK, NY 10016-2772
(646) 501-7300
Mailing address
111 E 210TH ST, BRONX, NY 10467-2401
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F308624
NY
Other
Enumeration date
02/28/2019
Last updated
08/09/2022
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