MEDICARE: DUKE BAILEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	341627	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	402812	NY

General Provider Information

NPI Number	:	1629420823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUKE BAILEY

Provider Business Mailing Address
First Line	:	1679 LEWIS RD
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-2312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2182 PITKIN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11207-3613
Country	:	US
Telephone Number	:	718-215-4011
Fax Number	:	718-215-4042

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2016
Last Update Date	:	02/03/2026

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Directions to “ DUKE BAILEY ” Practice Location

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