Provider Demographics
NPI:1942246673
Name:BAYNER, STEPHANIE M (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:BAYNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9522 63RD RD
Mailing Address - Street 2:531
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1142
Mailing Address - Country:US
Mailing Address - Phone:718-271-3548
Mailing Address - Fax:718-606-0719
Practice Address - Street 1:9522 63RD RD
Practice Address - Street 2:531
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1142
Practice Address - Country:US
Practice Address - Phone:718-271-3548
Practice Address - Fax:718-606-0719
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2314882081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI21940Medicare UPIN