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NPI Code Detail

MEDICARE: BAILEY WALSH

MEDICARE: BAILEY WALSH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-22-61720NJ

General Provider Information

NPI Number : 1629604814
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAILEY WALSH
Provider Business Mailing Address
First Line : 101 WILLOW AVE APT 3B
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-3659
Country : US
Telephone Number : 203-556-4487
Fax Number :
Provider Business Practice Location Address
First Line : 221 RIVER ST
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-5989
Country : US
Telephone Number : 201-510-1605
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2020
Last Update Date : 12/22/2025

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Directions to “ BAILEY WALSH ” Practice Location

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