Individual
JUAN MANUEL BAEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
41-61 KISSENA BLVD, FLUSHING, NY 11355-2686
(718) 663-5008
(718) 663-5008
Mailing address
55 WATER ST FL 2, NEW YORK, NY 10041-0010
(646) 680-2888
(516) 542-5556
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
254097
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03313471
—
NY
Enumeration date
01/28/2009
Last updated
09/24/2025
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