Provider Demographics
NPI:1427337393
Name:DR PHILIP R.BALDEO MEDICAL SERVICES,PC
Entity type:Organization
Organization Name:DR PHILIP R.BALDEO MEDICAL SERVICES,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:R
Authorized Official - Last Name:BALDEO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-845-8900
Mailing Address - Street 1:125-07 LIBERTY AVE
Mailing Address - Street 2:SOUTH RICHMOND HILL
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11419
Mailing Address - Country:US
Mailing Address - Phone:718-845-8900
Mailing Address - Fax:866-372-8750
Practice Address - Street 1:12507 LIBERTY AVE
Practice Address - Street 2:SOUTH RICHMOND HILL
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11419-2233
Practice Address - Country:US
Practice Address - Phone:718-845-8900
Practice Address - Fax:866-372-8750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty