| Doctor Name: | KIMBERLY BAGGIO |
| NPI Number: | 1275783128 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PNP |
| License Number: | 382013 |
| Business Practice Address: | 1999 Marcus Avenue Suite M18 Lake Success, NY - 11042 |
| Business Phone Number: | 5164666953 |
| Business Fax Number: | 5164665608 |
| Mailing Address: | 1999 Marcus Avenue, Suite M18 LAKE SUCCESS |
| State: | NY |
| Postal Code: | 11042 |
| Phone Number: | 5164666953 |
| Fax Number: | 5164665608 |
| NPI Enumeration Date: | 09/29/2008 |
| NPI Last Update Date: | 09/29/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 382013 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |