Provider Demographics
NPI:1811714892
Name:MENDEZ-BALDWIN, MARTHA MARIA (PHD)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:MARIA
Last Name:MENDEZ-BALDWIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MARTHA
Other - Middle Name:MARIA
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:41 FOREST LN
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-6509
Mailing Address - Country:US
Mailing Address - Phone:917-709-6843
Mailing Address - Fax:
Practice Address - Street 1:41 FOREST LN
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-6509
Practice Address - Country:US
Practice Address - Phone:917-709-6843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026681103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty