Healthcare Provider Details

I. General information

NPI: 1295564110
Provider Name (Legal Business Name): ALEXIA BAKER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2024
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

358 BEECH ST
HACKENSACK NJ
07601-1344
US

IV. Provider business mailing address

120 CHUBB AVE APT 241
LYNDHURST NJ
07071-3576
US

V. Phone/Fax

Practice location:
  • Phone: 201-487-8600
  • Fax:
Mailing address:
  • Phone: 646-275-5644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME00085701
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: