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General NPI Number Information
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NPI Number | 1467629618
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Entity Type | Organization
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Legal Business Name | BAKER EYE ASSOCIATES, PC
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 10/04/2011
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Provider Practice Location Address
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Address Line | 49 LOCUST ST SUITE 101
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City | DANVERS
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State | MA
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Zip | 01923-2239
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Country | US
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Telephone | 978-376-1637
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Fax | 978-304-0413
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Provider Business Mailing Address
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Address Line | 49 LOCUST ST SUITE 101
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City | DANVERS
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State | MA
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Zip | 01923-2239
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Country | US
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Telephone | 978-376-1637
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW DEARBORN BAKER
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Credential | O.D.
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Telephone | 978-376-1637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3075
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License Number State | MA
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