Healthcare Provider Details

I. General information

NPI: 1497676902
Provider Name (Legal Business Name): NATALIE BAEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 E 187TH ST APT 7
BRONX NY
10458-6842
US

IV. Provider business mailing address

724 E 187TH ST APT 7
BRONX NY
10458-6842
US

V. Phone/Fax

Practice location:
  • Phone: 347-310-1149
  • Fax:
Mailing address:
  • Phone: 347-310-1149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number1979306251
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: