Individual
MR. RICARDO LUIS BAEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
49 LAWRENCE AVE, POTSDAM, NY 13676-1889
(315) 274-9075
Mailing address
2125 RANDALL AVENUE, APT. 6M, BRONX, NY 10473
(347) 853-0915
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
016861
NY
Other
Enumeration date
08/21/2013
Last updated
07/09/2021
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