Provider Demographics
NPI:1669562989
Name:BARON, STEVEN TODD (PSYD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:TODD
Last Name:BARON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4250 SUNRISE HWY
Mailing Address - Street 2:SUITE # 103
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5338
Mailing Address - Country:US
Mailing Address - Phone:516-798-0354
Mailing Address - Fax:
Practice Address - Street 1:4250 SUNRISE HWY
Practice Address - Street 2:SUITE # 103
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5338
Practice Address - Country:US
Practice Address - Phone:516-798-0354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist