Provider Demographics
NPI:1053172361
Name:BAINS, BALJIT K (MD)
Entity type:Individual
Prefix:DR
First Name:BALJIT
Middle Name:K
Last Name:BAINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CLOTILDE CT
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-5515
Mailing Address - Country:US
Mailing Address - Phone:516-430-8981
Mailing Address - Fax:
Practice Address - Street 1:2525 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1705
Practice Address - Country:US
Practice Address - Phone:718-692-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY828491163WC1400X, 163WC1600X, 163WI0600X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1400XNursing Service ProvidersRegistered NurseCollege Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control