Healthcare Provider Details

I. General information

NPI: 1659767796
Provider Name (Legal Business Name): SIMA BAALBAKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 06/29/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 EASTCHESTER RD
BRONX NY
10461-2374
US

IV. Provider business mailing address

201 E 86TH ST APT 24G
NEW YORK NY
10028-3076
US

V. Phone/Fax

Practice location:
  • Phone: 718-405-8200
  • Fax:
Mailing address:
  • Phone: 256-483-1062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35410
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number298520
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: