MEDICARE: MARY BAFFOE

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	163W00000X	Registered Nurse	725223	NY
2	363LF0000X	Family Nurse Practitioner	F353894-01	NY

General Provider Information

NPI Number	:	1730016056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY BAFFOE

Provider Business Mailing Address
First Line	:	4231 BRUNER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2005
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1075 GERARD AVE APT 312
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-8862
Country	:	US
Telephone Number	:	516-455-6189
Fax Number	:

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

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/08/2026

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Directions to “ MARY BAFFOE ” Practice Location

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