Bayridge Medical Consultants
Exclusive Provider Organization in Brooklyn, NY. Organization (NPI-2).
NPI number1295840296
StatusActive
Last updated in NPPESApr 9, 2009
Details
- NPI
- 1295840296
- Entity type
- Organization (NPI-2)
- Legal business name
- Bayridge Medical Consultants
- Organization subpart
- No
- Enumeration date
- Aug 20, 2006
- Last updated
- Apr 9, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302F00000X | Exclusive Provider Organization | 118172 | NY | Yes |
Practice location
420 77th StreetBrooklyn, NY 11209
Phone 718-748-3838
Mailing address
176 Bertha PlStaten Island, NY 10301-3807
Phone 718-748-3492
Authorized official
Joseph J Tricarico
President
7187483838
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