Provider Demographics
NPI:1356683437
Name:BAYLE, KEN-MICHAEL S (DO)
Entity Type:Individual
Prefix:
First Name:KEN-MICHAEL
Middle Name:S
Last Name:BAYLE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:101 NICOLLS RD
Mailing Address - Street 2:HSC FLOOR 11 RM 20
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS HSC T-11 / 040
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-2894
Practice Address - Country:US
Practice Address - Phone:631-444-2020
Practice Address - Fax:631-444-2894
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2022-08-24
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Provider Licenses
StateLicense IDTaxonomies
NY298863208000000X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics