Provider Demographics
NPI:1083747869
Name:BATH MEDICAL, P.C.
Entity Type:Organization
Organization Name:BATH MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRZEGORCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-266-3399
Mailing Address - Street 1:2015 BATH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4857
Mailing Address - Country:US
Mailing Address - Phone:718-266-3399
Mailing Address - Fax:718-266-2773
Practice Address - Street 1:2015 BATH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4857
Practice Address - Country:US
Practice Address - Phone:718-266-3399
Practice Address - Fax:718-266-2773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty