Provider Demographics
NPI:1023218187
Name:BALDINA, GINA MARIE (ARDMS)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:BALDINA
Suffix:
Gender:F
Credentials:ARDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:THREE RIVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01080-1024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 NORTH ST
Practice Address - Street 2:
Practice Address - City:THREE RIVERS
Practice Address - State:MA
Practice Address - Zip Code:01080-1024
Practice Address - Country:US
Practice Address - Phone:413-283-8471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA569572471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography