Healthcare Provider Details

I. General information

NPI: 1467370577
Provider Name (Legal Business Name): ROBERT BAKER JR. CPRS, CRSP, CFRA,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 STULTS RD STE 137
DAYTON NJ
08810-1549
US

IV. Provider business mailing address

12 STULTS RD STE 137
DAYTON NJ
08810-1549
US

V. Phone/Fax

Practice location:
  • Phone: 732-908-2111
  • Fax:
Mailing address:
  • Phone: 732-908-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: