Provider Demographics
NPI:1215764071
Name:BAYCARE MEDICAL PC.
Entity type:Organization
Organization Name:BAYCARE MEDICAL PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMEH
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:ABUELKHIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-747-9063
Mailing Address - Street 1:8500 4TH AVE OFC ON4TH
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4662
Mailing Address - Country:US
Mailing Address - Phone:718-747-9063
Mailing Address - Fax:
Practice Address - Street 1:8500 4TH AVE OFC ON4TH
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-4662
Practice Address - Country:US
Practice Address - Phone:718-747-9063
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1235751876OtherNPI FOR OWNER (SAMEH ABUELKHIR, MD)