Provider Demographics
NPI:1801826557
Name:BALDWIN PSYCHOLOGICAL CONSULTANTS, LLP
Entity Type:Organization
Organization Name:BALDWIN PSYCHOLOGICAL CONSULTANTS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:516-868-3421
Mailing Address - Street 1:865 MERRICK RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-3338
Mailing Address - Country:US
Mailing Address - Phone:516-868-3421
Mailing Address - Fax:516-623-3644
Practice Address - Street 1:1311 VIRGINIA ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4630
Practice Address - Country:US
Practice Address - Phone:718-327-2909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004050103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05166Medicare ID - Type UnspecifiedGHI MEDICARE