Individual
BLAKE A BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
3411 WAYNE AVE, BRONX, NY 10467-2509
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
330911
NY
Other
Enumeration date
04/21/2021
Last updated
07/09/2024
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