Provider Demographics
NPI:1992988646
Name:REID, CAROLINE BASKIN (MS, LICPSYCHOANALYST)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:BASKIN
Last Name:REID
Suffix:
Gender:F
Credentials:MS, LICPSYCHOANALYST
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:REID
Other - Last Name:SORELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:245 WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06793-1520
Mailing Address - Country:US
Mailing Address - Phone:860-868-0419
Mailing Address - Fax:860-868-0722
Practice Address - Street 1:1651 3RD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3679
Practice Address - Country:US
Practice Address - Phone:917-837-2682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000397102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst