MEDICARE: SHERI BALD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	098435-01	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	098435-01	OTHER	NY	NY STATE CLINICAL SOCIAL WORK LICENSE

General Provider Information

NPI Number	:	1144390386
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERI BALD

Provider Business Mailing Address
First Line	:	503 LAWRENCE RD
Second Line	:
City	:	WEST HEMPSTEAD
State	:	NY
Zip	:	11552-2839
Country	:	US
Telephone Number	:	732-403-4841
Fax Number	:

Provider Business Practice Location Address
First Line	:	503 LAWRENCE RD
Second Line	:
City	:	WEST HEMPSTEAD
State	:	NY
Zip	:	11552-2839
Country	:	US
Telephone Number	:	732-403-4841
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	01/29/2025

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Directions to “ SHERI BALD ” Practice Location

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