Provider Demographics
NPI:1609159334
Name:BAILEY, MARIA ANN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ANN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3499 ROUTE 9 N
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3258
Mailing Address - Country:US
Mailing Address - Phone:732-625-3166
Mailing Address - Fax:
Practice Address - Street 1:3499 ROUTE 9 N
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3258
Practice Address - Country:US
Practice Address - Phone:732-996-2125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0150631363AM0700X
NJ25MP00267100363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical