Individual
HANNAH AMELIA BAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9197
Mailing address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-5123
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
276183
MA
2085R0202X
Diagnostic Radiology Physician
321310
NY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
321310
NY
Other
Enumeration date
06/19/2018
Last updated
04/19/2024
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