Individual
MR. LUDOVICO OCTAVIANO BAQUERIZA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PEDIATRIC NP
Contact information
Practice address
3415 BAINBRIDGE AVE, BRONX, NY 10467-2403
(718) 741-2150
Mailing address
754 BRONX RIVER RD APT B11, BRONXVILLE, NY 10708-7901
(347) 769-2511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
601107
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
383887
NY
Other
Enumeration date
12/23/2025
Last updated
12/23/2025
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