Keith Dominic Galino Baltazar, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA02226700 Issued in NJ

Practice address

2625 Morris Ave
Union, NJ 07083-5606

Phone

(908) 686-0840

NPI assigned

Nov 30, 2023

Last updated

Nov 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1881460830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 NEPTUNE AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073051711",
            "telephone_number": "201-736-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 MORRIS AVE",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835606",
            "telephone_number": "908-686-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALTAZAR",
        "first_name": "KEITH DOMINIC",
        "middle_name": "GALINO",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA02226700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick D Bailey, DMD
• Sadaysia A Baker
• Balance Mind & Wellness Psychiatry
• Lauren Baldonado, PH.D., BCBA-D
• David Balkan, MPT
• Rio Camille Baltazar
• Anuj Bapodra, MD
• Lori Barnett, LCSW
• Sarah Mia Barnum
• Everda Emmanuella Baron

• Physical Therapist in Union, NJ
• Providers in Union, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.