Provider Demographics
NPI:1497193163
Name:BAYDUR, SUSAN (LMSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BAYDUR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 W 108TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-2956
Mailing Address - Country:US
Mailing Address - Phone:212-663-3000
Mailing Address - Fax:212-663-3179
Practice Address - Street 1:551 W 125TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-3433
Practice Address - Country:US
Practice Address - Phone:212-678-7188
Practice Address - Fax:212-666-1583
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72087199104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker