Provider Demographics
NPI:1558309435
Name:TAYLOR, ELISABETH BALDWIN (MD)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:BALDWIN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2756 POST RD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-3003
Mailing Address - Country:US
Mailing Address - Phone:401-691-6000
Mailing Address - Fax:401-738-7718
Practice Address - Street 1:2756 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-3003
Practice Address - Country:US
Practice Address - Phone:401-691-6000
Practice Address - Fax:401-738-7718
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD078882084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI400136OtherBLUE CHIP
RI30145-3OtherBLUE CROSS
RI9001748Medicaid
RI15-35217OtherUNITED BEHAVIORAL HEALTH
RI30145-3OtherBLUE CROSS