Individual
MRS. JINA BAE NOCERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
154 LAFAYETTE ST, PALATINE BRIDGE, NY 13428-9715
(518) 673-5212
(518) 673-4337
Mailing address
154 LAFAYETTE ST, PALATINE BRIDGE, NY 13428-9715
(518) 673-5212
(518) 673-4337
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME110184
FL
208M00000X
Hospitalist Physician
224602
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02257876
—
NY
05
—
1013986
—
VT
05
—
3205029
—
MA
01
—
P00371407
RR MEDICARE
NY
01
—
P00995221
RR MEDICARE
FL
Enumeration date
06/22/2006
Last updated
11/27/2019
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