Provider Demographics
NPI:1972657963
Name:BALDWIN UFSC
Entity Type:Organization
Organization Name:BALDWIN UFSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, PUPIL SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIETRAFESA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-377-9283
Mailing Address - Street 1:960 HASTINGS ST
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-4738
Mailing Address - Country:US
Mailing Address - Phone:516-377-9283
Mailing Address - Fax:516-377-9311
Practice Address - Street 1:960 HASTINGS ST
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-4738
Practice Address - Country:US
Practice Address - Phone:516-377-9283
Practice Address - Fax:516-377-9311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01398512Medicaid