Provider Demographics
NPI:1376932301
Name:BAIKO, TAMMY S (MS)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:S
Last Name:BAIKO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 MERMAID AVE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-4405
Mailing Address - Country:US
Mailing Address - Phone:516-557-5174
Mailing Address - Fax:
Practice Address - Street 1:2501 MERMAID AVE
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-4405
Practice Address - Country:US
Practice Address - Phone:516-557-5174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-14
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst