Healthcare Provider Details

I. General information

NPI: 1518624527
Provider Name (Legal Business Name): KYRSTIN BALDINO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2021
Last Update Date: 11/24/2021
Certification Date: 11/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S. CLINTON AVE BUILDING H SUITE 135
ROCHESTER NY
14618
US

IV. Provider business mailing address

2400 S. CLINTON AVE BUILDING H SUITE 135
ROCHESTER NY
14618
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-7066
  • Fax: 585-341-7945
Mailing address:
  • Phone: 585-341-7066
  • Fax: 585-341-7945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number700599
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: