Provider Demographics
NPI:1275594715
Name:BAQI, NOOSHA (MD)
Entity Type:Individual
Prefix:
First Name:NOOSHA
Middle Name:
Last Name:BAQI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 5189
Mailing Address - Street 2:
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773-9744
Mailing Address - Country:US
Mailing Address - Phone:787-889-4539
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL HIMA- SAN PABLO
Practice Address - Street 2:AVE GENERAL VALERO # 404
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-655-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16,3572080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0016195Medicaid
NY0016195Medicaid
077552LZ6Medicare ID - Type Unspecified