Individual
MR. JOEL OLIVER BAXTER I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
4556 42ND ST APT 4D, SUNNYSIDE, NY 11104-2949
(929) 225-9342
Mailing address
4556 42ND ST APT 4D, SUNNYSIDE, NY 11104-2949
(929) 225-9342
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
706250
NY
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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