Healthcare Provider Details

I. General information

NPI: 1861013005
Provider Name (Legal Business Name): SANJEEV BALDEO DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2020
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 ROUTE 300
NEWBURGH NY
12550-5003
US

IV. Provider business mailing address

PO BOX 411730
BOSTON MA
02241-1730
US

V. Phone/Fax

Practice location:
  • Phone: 845-703-6999
  • Fax: 845-703-6297
Mailing address:
  • Phone: 845-703-6999
  • Fax: 845-703-6297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN007318
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: