Basic Information
| Provider Information | |||||||||
| NPI: | 1932355047 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAQUERO | ||||||||
| FirstName: | ANDRES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3059 STEINWAY ST APT 2A | ||||||||
| Address2: | |||||||||
| City: | ASTORIA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 111033806 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1825 EASTCHESTER RD | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104612301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5519962000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2008 | ||||||||
| LastUpdateDate: | 02/12/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 25MA08065700 | NJ | N | Allopathic & Osteopathic Physicians | Pediatrics | 207P00000X | A118090 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 25MA08065700 | NJ | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | P3285 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 208000000X | 247862 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | A118090 | CA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | P3285 | TX | N | Allopathic & Osteopathic Physicians | Pediatrics | 207P00000X | 247862 | NY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.