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General NPI Number Information
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NPI Number | 1164307153
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Entity Type | Individual
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Provider Name | NATHANIEL THOMAS BALDWIN DPT
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Gender | Male
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Dates
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Enumeration Date | 08/08/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 426 METACOM AVE
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City | WARREN
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State | RI
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Zip | 02885-2711
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Country | US
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Telephone | 401-903-2167
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Fax | 401-903-4976
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Provider Business Mailing Address
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Address Line | 4 RICHMOND SQ
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City | PROVIDENCE
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State | RI
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Zip | 02906-5117
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Country | US
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Telephone | 401-433-4172
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Fax | 401-433-0612
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT04019
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License Number State | RI
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