MEDICARE: MICHELLE BAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	226300000X	Kinesiotherapist

General Provider Information

NPI Number	:	1053922427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE BAY

Provider Business Mailing Address
First Line	:	3548 35TH ST APT 4A
Second Line	:
City	:	ASTORIA
State	:	NY
Zip	:	11106-1604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1217 JACKSON AVE
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-5501
Country	:	US
Telephone Number	:	212-362-6241
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2020
Last Update Date	:	08/11/2020

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Directions to “ MICHELLE BAY ” Practice Location

Language	Start Address	Practice Location

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