Provider Demographics
NPI:1134928245
Name:BAEWO CORP
Entity type:Organization
Organization Name:BAEWO CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COFOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:SUK
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-415-3399
Mailing Address - Street 1:200 RIVERSIDE BLVD APT 25E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10069-0904
Mailing Address - Country:US
Mailing Address - Phone:917-415-3399
Mailing Address - Fax:
Practice Address - Street 1:200 RIVERSIDE BLVD APT 25E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10069-0904
Practice Address - Country:US
Practice Address - Phone:917-415-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty