MEDICARE: JAMES JOSEPH BAYLIS L.C.S.W.

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	1041C0700X	Clinical Social Worker	038060	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780693689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES JOSEPH BAYLIS L.C.S.W.

Provider Business Mailing Address
First Line	:	PO BOX 31094
Second Line	:
City	:	HARTFORD
State	:	CT
Zip	:	06150-1094
Country	:	US
Telephone Number	:	518-952-8140
Fax Number	:	518-952-8287

Provider Business Practice Location Address
First Line	:	8002 KEW GARDENS RD
Second Line	:	SUITE 704
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-3600
Country	:	US
Telephone Number	:	718-520-1513
Fax Number	:	718-520-6460

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	04/04/2008

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