Beth P. Bailey, D.O.
Individual provider Active NPI Pediatrics Physician · Glen Head, NY
NPI 1043384613 · NPPES record last updated Mar 1, 2012
Key facts
- NPI
- 1043384613
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 206641-1 (NY)
- Practice address
- 333 Glen Head Rd
Suite 55
Glen Head, NY 11545-1947 - Phone
- (516) 671-8101
- Fax
- (516) 671-3237
- NPI assigned
- Nov 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 206641-1 | NY | MD | Pediatrics Physician |
Networks
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EBGIBD/Endpoint/EBGIBD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 206641-1 | NY | Yes |
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | 206641-1 | NY |
Addresses
Primary practice location
333 Glen Head Rd
Suite 55
Glen Head, NY 11545-1947
Mailing address
333 Glen Head Rd
Suite 55
Glen Head, NY 11545-1947
Phone (516) 671-8101
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02384889 | Medicaid | NY |
Other providers in Glen Head, NY
- Federica Avantaggiato
- Joshua Axelrod
- Ayesha Assad Medical PLLC
- Mikhail Azernov
- Shameila Bacchus
- Lauren Renee Baker
- Mazhar Baker
- Meghan Anne Barker
- Barrtmenschddspc
- Christine Baudin
All providers in Glen Head, NY · Pediatrics Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.