Provider Demographics
NPI:1386679017
Name:DAYSI BAEZ MD PC
Entity Type:Organization
Organization Name:DAYSI BAEZ MD PC
Other - Org Name:DAYSI BAEZ MD PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAYSI
Authorized Official - Middle Name:
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-997-0900
Mailing Address - Street 1:9777 QUEENS BLVD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3317
Mailing Address - Country:US
Mailing Address - Phone:718-997-0900
Mailing Address - Fax:718-997-6460
Practice Address - Street 1:9777 QUEENS BLVD
Practice Address - Street 2:SUITE 900
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3317
Practice Address - Country:US
Practice Address - Phone:718-997-0900
Practice Address - Fax:718-997-6460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196289207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
07658Medicare ID - Type Unspecified