Provider Demographics
NPI:1669346474
Name:BALDWIN, TALYA
Entity type:Individual
Prefix:
First Name:TALYA
Middle Name:
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 E GREENWAY PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4373
Mailing Address - Country:US
Mailing Address - Phone:602-877-9501
Mailing Address - Fax:602-798-9702
Practice Address - Street 1:2625 E GREENWAY PKWY STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-4373
Practice Address - Country:US
Practice Address - Phone:602-877-9501
Practice Address - Fax:602-798-9702
Is Sole Proprietor?:No
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician