Individual
JULISSA BAEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
232 E 12TH ST, UNIT 1G, NEW YORK, NY 10003-9151
(646) 524-6351
(646) 524-6362
Mailing address
2306 ESPLANADE AVE, BRONX, NY 10469-5408
(347) 275-2030
(347) 275-2030
Taxonomy
Speciality
Code
Description
License number
State
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
232901
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02797648
—
NY
Enumeration date
04/13/2007
Last updated
11/19/2012
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