Healthcare Provider Details

I. General information

NPI: 1669393807
Provider Name (Legal Business Name): SQUARE CARE MEDICAL GROUP, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 ROUTE 59 STE 102
SUFFERN NY
10901-5207
US

IV. Provider business mailing address

5801 POSTAL RD
CLEVELAND OH
44181-2184
US

V. Phone/Fax

Practice location:
  • Phone: 845-347-2204
  • Fax: 845-347-2205
Mailing address:
  • Phone: 612-299-1519
  • Fax: 516-758-2566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: MAX DOUGLAS BALDINGER
Title or Position: VP OPERATIONS
Credential:
Phone: 561-208-8616