Provider Demographics
NPI:1083782668
Name:BAECHER, JOSEPH (MSW)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:BAECHER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LETTS CR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950
Mailing Address - Country:US
Mailing Address - Phone:845-783-7495
Mailing Address - Fax:
Practice Address - Street 1:26 FIREMANS MEMORIAL DRIVE
Practice Address - Street 2:SUITE 205A
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970
Practice Address - Country:US
Practice Address - Phone:845-354-8408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRP014947104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
622OtherBCD
NYRP014947OtherSTATE LICENSE
NYN00442Medicare ID - Type Unspecified