Provider Demographics
NPI:1609431279
Name:BAYOL, MAXIME (DO)
Entity type:Individual
Prefix:
First Name:MAXIME
Middle Name:
Last Name:BAYOL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11716 240TH ST
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4016
Mailing Address - Country:US
Mailing Address - Phone:516-564-7152
Mailing Address - Fax:
Practice Address - Street 1:1101 STEWART AVE
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-4892
Practice Address - Country:US
Practice Address - Phone:516-222-0893
Practice Address - Fax:516-228-6560
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317366208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics