MEDICARE: BAKER PEDIATRICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician
3	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1194487397
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAKER PEDIATRICS LLC

Provider Business Mailing Address
First Line	:	34 THE PROMENADE
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-2127
Country	:	US
Telephone Number	:	551-355-1200
Fax Number	:	551-355-1212

Provider Business Practice Location Address
First Line	:	34 THE PROMENADE
Second Line	:
City	:	EDGEWATER
State	:	NJ
Zip	:	07020-2127
Country	:	US
Telephone Number	:	551-355-1200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ZEYAD BAKER
Credential	:	MD
Telephone Number	:	201-779-3460

Provider Enumeration Date	:	10/06/2021
Last Update Date	:	08/08/2022

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