Healthcare Provider Details

I. General information

NPI: 1427061100
Provider Name (Legal Business Name): KRISTEN A BAKER PA C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. KRISTEN A LANG

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 04/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

761 MAIN AVE
NORWALK CT
06851
US

IV. Provider business mailing address

61 EAST AVE
NORWALK CT
06851
US

V. Phone/Fax

Practice location:
  • Phone: 203-229-2000
  • Fax: 203-840-9001
Mailing address:
  • Phone: 203-838-8414
  • Fax: 203-857-5649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number000520
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number000520
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: