Provider Demographics
NPI:1265529770
Name:BAY MEDICAL PC
Entity type:Organization
Organization Name:BAY MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:RAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-236-4970
Mailing Address - Street 1:2273 65TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:718-236-5274
Practice Address - Street 1:2273 65TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4001
Practice Address - Country:US
Practice Address - Phone:718-236-4970
Practice Address - Fax:718-236-5274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212806261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG92612Medicare UPIN