Provider Demographics
NPI:1346542081
Name:BAY RIDGE MEDICAL CONSULTANTS PC
Entity Type:Organization
Organization Name:BAY RIDGE MEDICAL CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRICARICO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-748-3838
Mailing Address - Street 1:420 77TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3206
Mailing Address - Country:US
Mailing Address - Phone:718-748-3838
Mailing Address - Fax:718-748-3850
Practice Address - Street 1:420 77TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3206
Practice Address - Country:US
Practice Address - Phone:718-748-3838
Practice Address - Fax:718-748-3850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118172261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY160485OtherELDERPLAN
NY01637943Medicaid
NY694611OtherBLUE CROSS BLUE SHEILD
NY83493AFOtherGHI
NYIPO426OtherCIGNA
NY0T230POtherHIP HMO
NY042584OtherAETNA HMO
NYP1596974OtherOXFORDPLAN
NY83493AFOtherGHI