Provider Demographics
NPI:1679539027
Name:BAIOCCO, PETER JULIO (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JULIO
Last Name:BAIOCCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1317 3RD AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2995
Mailing Address - Country:US
Mailing Address - Phone:212-734-8811
Mailing Address - Fax:212-472-5133
Practice Address - Street 1:1317 3RD AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2995
Practice Address - Country:US
Practice Address - Phone:212-734-8811
Practice Address - Fax:212-472-5133
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY138746207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133500991OtherUNITED HEALTHCARE
NYB95521OtherHIP
133500991OtherCIGNA
NY133500991OtherHEALTHNET
NYP379271OtherOXFORD
NYB95521OtherHIP
NYB95521Medicare UPIN