Provider Demographics
NPI:1902984339
Name:BALDEO, RUDOLPH LAURENCE (MD)
Entity Type:Individual
Prefix:
First Name:RUDOLPH
Middle Name:LAURENCE
Last Name:BALDEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4124
Mailing Address - Country:US
Mailing Address - Phone:516-739-3360
Mailing Address - Fax:
Practice Address - Street 1:WINTHROP UNIVERSITY HOSPITAL
Practice Address - Street 2:259 FIRST STREET
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501
Practice Address - Country:US
Practice Address - Phone:516-663-8767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY240897146D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant