Provider Demographics
NPI:1619296878
Name:BAPTISTE, DADRIE FREDA (MD)
Entity Type:Individual
Prefix:
First Name:DADRIE
Middle Name:FREDA
Last Name:BAPTISTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 NIAGARA FALLS BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-3302
Mailing Address - Fax:833-953-2016
Practice Address - Street 1:2666 W STATE ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1825
Practice Address - Country:US
Practice Address - Phone:716-701-1700
Practice Address - Fax:716-701-1717
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD466760208600000X, 208C00000X
NY307424208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery