Basic Information
| Provider Information | |||||||||
| NPI: | 1700941861 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BALDINO | ||||||||
| FirstName: | CATHY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNP PEDIATRICS | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 522 S CLINTON ST | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212244005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103428025 | ||||||||
| FaxNumber: | 4102634086 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 FORBES ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214011538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102636363 | ||||||||
| FaxNumber: | 4102634086 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0200X | R134748 | MD | Y | Nursing Service Providers | Registered Nurse | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | MB0956245 | 01 | MH | DEA | OTHER | R134748 | 01 | MH | STATE LICENSE | OTHER |