Provider Demographics
NPI:1407129034
Name:BAILEY, DANA V
Entity Type:Individual
Prefix:MISS
First Name:DANA
Middle Name:V
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 PARKSIDE AVE
Mailing Address - Street 2:APT 6F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1361
Mailing Address - Country:US
Mailing Address - Phone:347-458-5727
Mailing Address - Fax:
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:9TH FLOOR SUITE 9V
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:121-226-3398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-13
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305779363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner