Healthcare Provider Details

I. General information

NPI: 1154866234
Provider Name (Legal Business Name): BAYON MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2016
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 UNION ST # 402
LYNN MA
01901-1353
US

IV. Provider business mailing address

280 UNION ST STE 402
LYNN MA
01901-1353
US

V. Phone/Fax

Practice location:
  • Phone: 781-780-7755
  • Fax: 781-598-0243
Mailing address:
  • Phone: 781-780-7755
  • Fax: 781-598-0243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number222926
License Number StateMA

VIII. Authorized Official

Name: VLADIMIR BATRIN
Title or Position: PRACTICE ADMINISTRATOR
Credential: MS
Phone: 857-452-6356