Provider Demographics
NPI:1780337006
Name:BALDEOSINGH, KERRY (RN)
Entity type:Individual
Prefix:MR
First Name:KERRY
Middle Name:
Last Name:BALDEOSINGH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11171 158TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433-3823
Mailing Address - Country:US
Mailing Address - Phone:574-360-0331
Mailing Address - Fax:
Practice Address - Street 1:11171 158TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11433-3823
Practice Address - Country:US
Practice Address - Phone:574-360-0331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY575175163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse