Provider Demographics
NPI:1326225335
Name:BAIOCCO, MAURO S
Entity Type:Individual
Prefix:
First Name:MAURO
Middle Name:S
Last Name:BAIOCCO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 BRIDGE ST
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5292
Mailing Address - Country:US
Mailing Address - Phone:347-232-6023
Mailing Address - Fax:
Practice Address - Street 1:397 BRIDGE ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5292
Practice Address - Country:US
Practice Address - Phone:347-232-6023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool