Healthcare Provider Details

I. General information

NPI: 1487103073
Provider Name (Legal Business Name): TANYA BAILEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2016
Last Update Date: 03/14/2024
Certification Date: 03/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 SAINT NICHOLAS AVE APT 2B
NEW YORK NY
10031-2921
US

IV. Provider business mailing address

1480 PARKCHESTER RD APT 5F
BRONX NY
10462-7639
US

V. Phone/Fax

Practice location:
  • Phone: 646-943-3820
  • Fax:
Mailing address:
  • Phone: 646-943-3820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number932470
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: