Provider Demographics
NPI:1285996777
Name:BAEZ, CHENIN
Entity type:Individual
Prefix:
First Name:CHENIN
Middle Name:
Last Name:BAEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 RIVERDALE AVE
Mailing Address - Street 2:APT 2B
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-3566
Mailing Address - Country:US
Mailing Address - Phone:914-423-4594
Mailing Address - Fax:
Practice Address - Street 1:517 RIVERDALE AVE
Practice Address - Street 2:APT 2B
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-3566
Practice Address - Country:US
Practice Address - Phone:914-423-4594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist