Provider Demographics
NPI:1356948913
Name:BAILEY, DYLAN CHRISTOPHER (RN)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:CHRISTOPHER
Last Name:BAILEY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 ROUTE 146
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3643
Mailing Address - Country:US
Mailing Address - Phone:518-881-0331
Mailing Address - Fax:518-881-0418
Practice Address - Street 1:970 ROUTE 146
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3643
Practice Address - Country:US
Practice Address - Phone:518-881-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY728921163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse