Jerdene Bachus

NPI #1124756515 in Plainview, New York

Provider Information

NPI Number: 1124756515
Entity Type: Individual
Name: Jerdene Bachus
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Aug 12, 2022
Last Updated: Aug 12, 2022

Practice Location

Address: 255 EXECUTIVE DR
City: Plainview
State: New York
ZIP Code: 11803-1718
Phone: (347) 965-4381

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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