Provider Demographics
NPI:1306102827
Name:BAYARD, MICAELA F (MD)
Entity type:Individual
Prefix:DR
First Name:MICAELA
Middle Name:F
Last Name:BAYARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2520 30TH AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-2448
Mailing Address - Country:US
Mailing Address - Phone:718-808-7777
Mailing Address - Fax:718-808-7757
Practice Address - Street 1:2520 30TH AVE FL 5
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102
Practice Address - Country:US
Practice Address - Phone:718-808-7777
Practice Address - Fax:718-808-7757
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY290687207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04852071Medicaid