MEDICARE: AALIYAH PAIGE HOO KIM- BAKER RN

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	363LF0000X	Family Nurse Practitioner	RN2269028	MA
2	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	RN2385984	MA

General Provider Information

NPI Number	:	1497579957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AALIYAH PAIGE HOO KIM- BAKER RN

Provider Business Mailing Address
First Line	:	191-205 PARKINGWAY
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169
Country	:	US
Telephone Number	:	617-820-5968
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 COLUMBIA RD
Second Line	:
City	:	DORCHESTER
State	:	MA
Zip	:	02121-3409
Country	:	US
Telephone Number	:	617-237-6838
Fax Number	:

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

Provider Enumeration Date	:	11/12/2024
Last Update Date	:	05/22/2025

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