| Mr Bryan Baracaldo, | |
|
13519 77th Ave, Flushing, NY 11367-2823 | |
| (516) 662-4487 | |
| Not Available |
| Full Name | Mr Bryan Baracaldo |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Adult Health |
| Location | 13519 77th Ave, Flushing, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528599396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2200X | Nurse Practitioner - Adult Health | 308171 (New York) | Primary |
| Entity Name | Memorial Medical Consultation Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053382523 PECOS PAC ID: 6406755081 Enrollment ID: O20040102000372 |
| Entity Name | Memorial Solid Tumor Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699746172 PECOS PAC ID: 4082503354 Enrollment ID: O20040313000668 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Bryan Baracaldo, 13519 77th Ave, Flushing, NY 11367-2823 Ph: (516) 662-4487 | Mr Bryan Baracaldo, 13519 77th Ave, Flushing, NY 11367-2823 Ph: (516) 662-4487 |
Peter Jaesung Jo, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5645 Main St, Flushing, NY 11355 Phone: 917-340-4637 | |
Angelina Yushuvayev, WHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 14703 77th Rd, Flushing, NY 11367 Phone: 917-859-3721 | |
Chunying Shao, NP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 3808 Union St Ste 6b, Flushing, NY 11354 Phone: 718-888-1125 | |
Esther Hyunhee Lim, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5645 Main St, Flushing, NY 11355 Phone: 718-670-2388 | |
Ms. Tanya K. Walker, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3515 Parsons Blvd, Flushing, NY 11354 Phone: 718-961-3500 | |
Linda Hosford, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5645 Main St, Flushing, NY 11355 Phone: 718-670-2627 Fax: 516-437-4167 | |
Ms. Nenita Ventulan Sausa, NURSE PRACTITIONER Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4500 Parsons Blvd, Flushing, NY 11355 Phone: 718-670-5640 Fax: 718-670-5711 |