Healthcare Provider Details

I. General information

NPI: 1306770797
Provider Name (Legal Business Name): BAEZ MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 RTE 46
LITTLE FERRY NJ
07643-1407
US

IV. Provider business mailing address

69 AVENUE F
LODI NJ
07644-1911
US

V. Phone/Fax

Practice location:
  • Phone: 551-337-4601
  • Fax:
Mailing address:
  • Phone: 646-338-9572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name: VANESSA BAEZ
Title or Position: OWNER
Credential:
Phone: 646-339-9572