MEDICARE: JOANNA BAYNES

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
1	104100000X	Social Worker	114122	NY

General Provider Information

NPI Number	:	1760144877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA BAYNES

Provider Business Mailing Address
First Line	:	1534 ERICSON PL APT 2J
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-5451
Country	:	US
Telephone Number	:	646-546-8076
Fax Number	:

Provider Business Practice Location Address
First Line	:	1534 ERICSON PL APT 2J
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-5451
Country	:	US
Telephone Number	:	646-546-8076
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2021
Last Update Date	:	10/06/2021

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Directions to “ JOANNA BAYNES ” Practice Location

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