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General NPI Number Information
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NPI Number | 1023486818
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Entity Type | Organization
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Legal Business Name | HELEN M BAIETTO PHD PSYCHOLOGIST PC
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Dates
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Enumeration Date | 09/10/2015
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 299 MAIN STREET
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City | NORTHPORT
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State | NY
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Zip | 11768-1704
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Country | US
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Telephone | 631-754-4525
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Fax | 631-754-4525
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Provider Business Mailing Address
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Address Line | 299 MAIN STREET
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City | NORTHPORT
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State | NY
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Zip | 11768-1704
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Country | US
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Telephone | 631-754-4525
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Fax | 631-754-4525
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Authorized Official
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Title or Position | DIRECT OWNER
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Name | DR. HELEN M. BAIETTO
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Credential | PHD
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Telephone | 631-754-4525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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