Healthcare Provider Details

I. General information

NPI: 1891785002
Provider Name (Legal Business Name): BRIAN C BAKER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 REEF RD
FAIRFIELD CT
06824-5922
US

IV. Provider business mailing address

133 REEF RD
FAIRFIELD CT
06824-5922
US

V. Phone/Fax

Practice location:
  • Phone: 203-259-4939
  • Fax: 203-259-3793
Mailing address:
  • Phone: 203-259-4939
  • Fax: 203-259-3793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number00582CT
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: