Provider Demographics
NPI:1790322477
Name:BAY RIDGE MEDICAL CARE PLLC
Entity Type:Organization
Organization Name:BAY RIDGE MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEHRDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HEDAYATNIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-833-7246
Mailing Address - Street 1:116 SANDFORD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-2987
Mailing Address - Country:US
Mailing Address - Phone:718-833-0033
Mailing Address - Fax:
Practice Address - Street 1:370 BAY RIDGE PKWY LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3176
Practice Address - Country:US
Practice Address - Phone:718-833-0033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty