Provider Demographics
NPI:1457650152
Name:BAY MEDICAL CARE SERVICES PLLC
Entity Type:Organization
Organization Name:BAY MEDICAL CARE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ISOLDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSAPOK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-273-2700
Mailing Address - Street 1:42 RICHMOND TER
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-1909
Mailing Address - Country:US
Mailing Address - Phone:718-273-2700
Mailing Address - Fax:718-273-2795
Practice Address - Street 1:42 RICHMOND TER
Practice Address - Street 2:1ST FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-1909
Practice Address - Country:US
Practice Address - Phone:718-273-2700
Practice Address - Fax:718-273-2795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02846913Medicaid
NYA300000099Medicare PIN