Provider Demographics
NPI:1407581630
Name:AZLING, BAILEY (PA)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:AZLING
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Gender:
Credentials:PA
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Other - Middle Name:
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Mailing Address - Street 1:BMCHS PROVIDER ENROLLMENT
Mailing Address - Street 2:960 MASSACHUSETTS AVE FLR 2
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:SEMC - UROLOGY - INPATIENT
Practice Address - Street 2:736 CAMBRIDGE STREET
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-787-8181
Practice Address - Fax:617-787-4644
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2025-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
MAPA100890363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant