Individual
LAINIE BAXT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
42 BERKLEY LN, SYOSSET, NY 11791-6108
(917) 689-1444
Mailing address
42 BERKLEY LN, SYOSSET, NY 11791-6108
(917) 689-1444
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
015278-1
NY
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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