1649601899 NPI number — MRS. DEBORAH MARIE BALDINO LMSW

Table of content: MRS. DEBORAH MARIE BALDINO LMSW (NPI 1649601899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649601899 NPI number — MRS. DEBORAH MARIE BALDINO LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BALDINO
Provider First Name:
DEBORAH
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROOT
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1649601899
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 ERIN CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ISLIP TERRACE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11752-2401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-650-1194
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11 ERIN CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ISLIP TERRACE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11752-2401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-650-1194
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  051558-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)