Provider Demographics
NPI:1407197700
Name:BAILEY, BRENDA D (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:D
Last Name:BAILEY
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 1:4250 FEDERAL DR
Mailing Address - Street 2:IMMIGRATION HEALTH SERVICES, BFDF
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1094
Mailing Address - Country:US
Mailing Address - Phone:585-344-5151
Mailing Address - Fax:585-345-1896
Practice Address - Street 1:4250 FEDERAL DR
Practice Address - Street 2:IMMIGRATION HEALTH SERVICES, BFDF
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1094
Practice Address - Country:US
Practice Address - Phone:585-344-5151
Practice Address - Fax:585-345-1896
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039635207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine