Provider Demographics
NPI:1639943723
Name:TONY BAO NP IN FAMILY HEALTH, P.C.
Entity Type:Organization
Organization Name:TONY BAO NP IN FAMILY HEALTH, P.C.
Other - Org Name:AESTHETICUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:347-374-5026
Mailing Address - Street 1:2685 E 22ND ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2871
Mailing Address - Country:US
Mailing Address - Phone:347-977-4507
Mailing Address - Fax:
Practice Address - Street 1:86 BRIGHTON 1ST PL FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7473
Practice Address - Country:US
Practice Address - Phone:347-374-5026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty