=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902934177
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANNETTE BAGGOTT MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/01/2007
-----------------------------------------------------
Last Update Date | 03/07/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 371 MERRICK ROAD SUITE 203
-----------------------------------------------------
City | ROCKVILLE CENTRE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11570-5301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-799-2554
-----------------------------------------------------
Fax | 516-766-0744
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 371 MERRICK ROAD SUITE 203
-----------------------------------------------------
City | ROCKVILLE CENTRE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11570-5301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-766-4500
-----------------------------------------------------
Fax | 516-766-0744
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CPC
-----------------------------------------------------
Name | MRS. VALERIE S ALLBRIGHT
-----------------------------------------------------
Credential | CPC
-----------------------------------------------------
Telephone | 516-616-4982
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VX0000X
-----------------------------------------------------
Taxonomy Name | Obstetrics Physician
-----------------------------------------------------
License Number | 173851
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------