Healthcare Provider Details

I. General information

NPI: 1629262241
Provider Name (Legal Business Name): JESSICA M. BAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 08/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MUNRO AVE
CAPE MAY NJ
08204-5000
US

IV. Provider business mailing address

87B ROUTE 50
OCEAN VIEW NJ
08230-1117
US

V. Phone/Fax

Practice location:
  • Phone: 609-898-6960
  • Fax: 609-898-6268
Mailing address:
  • Phone: 609-369-0843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: