Healthcare Provider Details

I. General information

NPI: 1720879455
Provider Name (Legal Business Name): OSCAR OLIVER BAKER PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W 37TH ST FL 4
NEW YORK NY
10018-4228
US

IV. Provider business mailing address

301 W 37TH ST FL 4
NEW YORK NY
10018-4228
US

V. Phone/Fax

Practice location:
  • Phone: 212-465-8304
  • Fax:
Mailing address:
  • Phone: 212-465-8304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number406721
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: