Healthcare Provider Details

I. General information

NPI: 1346304011
Provider Name (Legal Business Name): GERRY BAIRD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GERRY ANNINO LCSW

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 EDWARDS ST
NEW HAVEN CT
06511-3933
US

IV. Provider business mailing address

93 EDWARDS ST
NEW HAVEN CT
06511-3933
US

V. Phone/Fax

Practice location:
  • Phone: 203-777-8648
  • Fax: 203-785-0617
Mailing address:
  • Phone: 860-304-5088
  • Fax: 203-772-0051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: