Individual
JOSE A BAEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
707WEST 171 STREET, SUITE W, NEW YORK, NY 10032
(212) 927-4765
(212) 927-4857
Mailing address
155 SAINT JOHNS AVE, YONKERS, NY 10704-2913
(914) 969-7921
(914) 969-8149
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
197338-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01530354
—
NY
Enumeration date
06/23/2006
Last updated
10/16/2013
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