Provider Demographics
NPI:1437629433
Name:CRAIG BALDENHOFER MD PLLC
Entity Type:Organization
Organization Name:CRAIG BALDENHOFER MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BALDENHOFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-255-9800
Mailing Address - Street 1:338 BERRY ST APT 6A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-5250
Mailing Address - Country:US
Mailing Address - Phone:917-774-0071
Mailing Address - Fax:212-255-9801
Practice Address - Street 1:115 W 27TH ST FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6217
Practice Address - Country:US
Practice Address - Phone:212-255-9800
Practice Address - Fax:212-255-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty