Most Relevant Information
Provider Data
| NPI Number: | 1003444670 |
| Provider Name: | MINDY A BAUCICOT MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/30/2020 |
| Last Updated: | 03/30/2020 |
Provider Practice Location
101 NICOLLS RD FL HSC T-9R
STONY BROOK
NY
117948091
Practice Location Phone/Fax
| Phone: | 6314442783 |
| Fax: | 6314448954 |
Provider Mailing Location
101 NICOLLS RD FL HSC T-9R
STONY BROOK
NY
117948091
Provider Mailing Phone/Fax
| Phone: | 6314442783 |
| Fax: | 6314448954 |