Provider Demographics
NPI:1245393958
Name:BAILS, DOUGLAS BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:BRIAN
Last Name:BAILS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:67 DEBBIE PL
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1705
Mailing Address - Country:US
Mailing Address - Phone:908-898-1948
Mailing Address - Fax:908-898-0095
Practice Address - Street 1:462 FIRST AVENUE
Practice Address - Street 2:BELLEVUE HOSPITAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-562-2355
Practice Address - Fax:212-263-1048
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2014-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY189058207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF72554Medicare UPIN