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Individual

BRIAN M BALDWIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
6080 JERICHO TPKE, SUITE 310, COMMACK, NY 11725-2850
(516) 671-9535
Mailing address
6080 JERICHO TPKE, SUITE 310, COMMACK, NY 11725-2850
(516) 671-9535

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PR023997-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0049336
GHI
NY
01
064653
VYTRA HEALTHCARE
NY
01
4575961
AETNA
NY
01
P2086423
OXFORD HEALTH
NY
Enumeration date
07/18/2006
Last updated
07/08/2007
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