Healthcare Provider Details

I. General information

NPI: 1275465536
Provider Name (Legal Business Name): KUNIL BAE MD, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15408 NORTHERN BLVD STE 2I
FLUSHING NY
11354-5042
US

IV. Provider business mailing address

15408 NORTHERN BLVD STE 2I
FLUSHING NY
11354-5042
US

V. Phone/Fax

Practice location:
  • Phone: 718-358-3151
  • Fax: 718-358-4151
Mailing address:
  • Phone: 718-358-3151
  • Fax: 718-358-4151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KUNIL BAE
Title or Position: MD
Credential: MD
Phone: 917-715-5515