Individual
KAINA MACIEL BAEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
579 COURTLANDT AVE, BRONX, NY 10451-5013
(718) 485-2100
Mailing address
579 COURTLANDT AVE, BRONX, NY 10451-5013
(718) 485-2100
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
628601965
—
NY
Enumeration date
05/29/2020
Last updated
05/29/2020
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