Individual
BARBARA M BAZEMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
998 CROOKED HILL RD, BRENTWOOD, NY 11717-1019
(631) 796-9152
Mailing address
1511 E FORKS RD, BAY SHORE, NY 11706-3108
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
719716
NY
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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