Provider Demographics
NPI:1558964148
Name:BARTLEY-BALDWIN, BARBARA ELEANOR (LMT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELEANOR
Last Name:BARTLEY-BALDWIN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 LITTLE NECK PKWY APT 27B
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1749
Mailing Address - Country:US
Mailing Address - Phone:917-803-1056
Mailing Address - Fax:
Practice Address - Street 1:4001 LITTLE NECK PKWY APT 27B
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11363-1749
Practice Address - Country:US
Practice Address - Phone:917-803-1056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003836225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist