Basic Information
Provider Information
NPI: 1215369806
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BALDEO
FirstName: NOVITA
MiddleName: CINDY
NamePrefix:  
NameSuffix:  
Credential: D.P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 350 NEW FIDELITY CT
Address2:  
City: GARNER
State: NC
PostalCode: 275292665
CountryCode: US
TelephoneNumber: 9192582714
FaxNumber:  
Practice Location
Address1: 1300 N CHARLOTTE ST STE 14A
Address2:  
City: POTTSTOWN
State: PA
PostalCode: 194642351
CountryCode: US
TelephoneNumber: 4847524372
FaxNumber: 4847524376
Other Information
ProviderEnumerationDate: 08/06/2013
LastUpdateDate: 02/15/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/15/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
PT02727801PASTATE LICENSUREOTHER


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