Healthcare Provider Details

I. General information

NPI: 1720991995
Provider Name (Legal Business Name): BAILIN MEDICAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 STRATFORD RD APT 6D
BROOKLYN NY
11218-5374
US

IV. Provider business mailing address

6614 AVENUE U STE 93636
BROOKLYN NY
11234-6021
US

V. Phone/Fax

Practice location:
  • Phone: 203-723-3421
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALEXANDRA BAILIN
Title or Position: MEMBER-MANAGER
Credential: MD
Phone: 203-723-3421