Provider Demographics
NPI:1093102865
Name:RLB ALTERNATIVE CARE INC
Entity Type:Organization
Organization Name:RLB ALTERNATIVE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:347-853-0915
Mailing Address - Street 1:574 E 170TH ST
Mailing Address - Street 2:C/O RICARDO L. BAEZ
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-2304
Mailing Address - Country:US
Mailing Address - Phone:347-853-0915
Mailing Address - Fax:
Practice Address - Street 1:574 E 170TH ST
Practice Address - Street 2:C/O RICARDO L. BAEZ
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-2304
Practice Address - Country:US
Practice Address - Phone:347-853-0915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016861363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty