Healthcare Provider Details

I. General information

NPI: 1265256077
Provider Name (Legal Business Name): BRITTNEY BAILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2024
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 TIMES SQ
NEW YORK NY
10036-6564
US

IV. Provider business mailing address

3 TIMES SQ
NEW YORK NY
10036-6564
US

V. Phone/Fax

Practice location:
  • Phone: 212-463-0400
  • Fax:
Mailing address:
  • Phone: 516-606-6716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: