Individual
MS. JILL DWORKIN BAZOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
573 BEDFORD RD., 2ND FLR., BEDFORD HILLS, NY 10507
(914) 689-3655
Mailing address
26 AUTUMN RIDGE RD., POUND RIDGE, NY 10576
(914) 689-3655
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
02/24/2017
Last updated
02/24/2017
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