Dr. Nicholas Baialardo
Nurse Practitioner, Family in Port Jefferson Station, NY. Individual provider (NPI-1).
NPI number1801607866
StatusActive
Last updated in NPPESJan 17, 2025
Details
- NPI
- 1801607866
- Entity type
- Individual (NPI-1)
- Name
- Dr. Nicholas Baialardo
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 17, 2025
- Certification date
- Jan 17, 2025
- Last updated
- Jan 17, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 355798 | NY | Yes |
Practice location
1500 Route 112 Bldg 1Port Jefferson Station, NY 11776-8055
Phone 631-751-3000
Mailing address
1500 Route 112 Bldg 1Port Jefferson Station, NY 11776-8055
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