MEDICARE: ELLEN P BAKER AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	00-1313	NY
2	235Z00000X	Speech-Language Pathologist	00-1312	NY

General Provider Information

NPI Number	:	1326114646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLEN P BAKER AU.D.

Provider Business Mailing Address
First Line	:	1503 E 22ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5122
Country	:	US
Telephone Number	:	718-338-1736
Fax Number	:	718-252-5666

Provider Business Practice Location Address
First Line	:	1503 E 22ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-5122
Country	:	US
Telephone Number	:	718-338-1736
Fax Number	:	718-252-5666

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	09/11/2025

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