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General NPI Number Information
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NPI Number | 1871727438
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Entity Type | Individual
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Provider Name | JACQUELINE BAKER M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 125 E 72ND ST SUITE 1A
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City | NEW YORK
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State | NY
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Zip | 10021-4250
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Country | US
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Telephone | 211-298-8650
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Fax |
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Provider Business Mailing Address
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Address Line | 125 E 72ND ST SUITE 1A
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City | NEW YORK
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State | NY
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Zip | 10021-4250
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Country | US
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Telephone | 211-298-8650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 260548
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | 260548
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License Number State | NY
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