Individual
MR. BRIAN DAVID BAXLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
450 CLARKSON AVE # 50, BROOKLYN, NY 11203-2056
(718) 951-7548
Mailing address
6 ILSA CT, EAST NORTHPORT, NY 11731-4621
(718) 951-7548
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
009697-1
NY
Other
Enumeration date
08/09/2007
Last updated
08/18/2007
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