MEDICARE: VANESSA BAILEY HEALTHY-GEN

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	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1922679893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANESSA BAILEY HEALTHY-GEN

Provider Business Mailing Address
First Line	:	1478 ASTOR AVE APT 1
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-5813
Country	:	US
Telephone Number	:	646-706-2905
Fax Number	:

Provider Business Practice Location Address
First Line	:	1478 ASTOR AVE APT 1
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-5813
Country	:	US
Telephone Number	:	646-706-2905
Fax Number	:

Authorized Official
Title or Position	:	HEALTH EDUCATOR
Name	:	MS. VANESSA BAILEY
Credential	:
Telephone Number	:	646-706-2905

Provider Enumeration Date	:	07/01/2021
Last Update Date	:	07/01/2021

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