Provider Demographics
NPI:1144246323
Name:PHILIP BAI, M.D. LLC.
Entity Type:Organization
Organization Name:PHILIP BAI, M.D. LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:Y
Authorized Official - Last Name:BAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-925-4601
Mailing Address - Street 1:401 HAMBURG TPKE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2154
Mailing Address - Country:US
Mailing Address - Phone:973-925-4601
Mailing Address - Fax:973-925-4604
Practice Address - Street 1:401 HAMBURG TPKE
Practice Address - Street 2:SUITE 101
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2154
Practice Address - Country:US
Practice Address - Phone:973-925-4601
Practice Address - Fax:973-925-4604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA056388174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5476500Medicaid
NJ027291Medicare ID - Type Unspecified
NJ5476500Medicaid