Provider Demographics
NPI:1295523322
Name:BAEZ, JOANN
Entity type:Individual
Prefix:
First Name:JOANN
Middle Name:
Last Name:BAEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 STOCKHOLM ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-1330
Mailing Address - Country:US
Mailing Address - Phone:347-542-9181
Mailing Address - Fax:
Practice Address - Street 1:1819 STOCKHOLM ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-1330
Practice Address - Country:US
Practice Address - Phone:347-542-9181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist