Individual
MR. BRENT P BAYNON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1500 HEMPSTEAD TPKE, EAST MEADOW, NY 11554-1551
(516) 739-7733
Mailing address
41 DONCASTER AVE, WEST ISLIP, NY 11795-1220
(631) 492-0034
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
100287
NY
Other
Enumeration date
10/12/2021
Last updated
06/09/2025
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