Provider Demographics
NPI:1649492950
Name:BAGDONAS, REBECCA LYNN (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:BAGDONAS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:2 CATHARINE ST INFIRMARY ANESTHESIA ASSOCIATES LLP
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12602
Mailing Address - Country:US
Mailing Address - Phone:866-868-8415
Mailing Address - Fax:845-790-2675
Practice Address - Street 1:310 E 14TH STREET
Practice Address - Street 2:NY EYE & EAR INFIRMARY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-979-4000
Practice Address - Fax:845-790-2675
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2008-11-19
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Provider Licenses
StateLicense IDTaxonomies
NY2288041207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02899356Medicaid
NY89574LL431Medicare PIN
NY02899356Medicaid