MEDICARE: DR. DANETTE MICHELE 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	237600000X	Audiologist-Hearing Aid Fitter	002458	NY
2	237600000X	Audiologist-Hearing Aid Fitter	14000038191	NY

General Provider Information

NPI Number	:	1801805650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANETTE MICHELE BAKER AU.D.

Provider Business Mailing Address
First Line	:	352 7TH AVE
Second Line	:	SUITE 1002
City	:	NEW YORK
State	:	NY
Zip	:	10001-5012
Country	:	US
Telephone Number	:	212-379-6596
Fax Number	:	212-379-6598

Provider Business Practice Location Address
First Line	:	352 7TH AVE
Second Line	:	SUITE 1002
City	:	NEW YORK
State	:	NY
Zip	:	10001-5012
Country	:	US
Telephone Number	:	212-379-6596
Fax Number	:	212-379-6598

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	09/11/2014

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