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Organization

JOSE A BAEZ MD PC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ANANIA PENA-BAEZ NURSE (ADMINISTRATOR)
(212) 927-4765
Entity
Organization

Contact information

Practice address
707 W 171ST ST STE W, NEW YORK, NY 10032-2811
(212) 927-4765
(212) 927-4765
Mailing address
155 SAINT JOHNS AVE, YONKERS, NY 10704-2913
(212) 927-4765
(212) 927-4857

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
197338
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01530354
NY
Enumeration date
03/02/2012
Last updated
03/27/2012
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