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NPI Code Detail

MEDICARE: MS. MEGAN FORTTRELL BAKER PA

MEDICARE:  MS. MEGAN FORTTRELL BAKER  PA
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
1363AM0700XMedical Physician Assistant010703NY

General Provider Information

NPI Number : 1992727325
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MEGAN FORTTRELL BAKER PA
Provider Business Mailing Address
First Line : 214 CORNELIA ST
Second Line : SUITE 203
City : PLATTSBURGH
State : NY
Zip : 12901-2317
Country : US
Telephone Number : 518-563-2404
Fax Number :
Provider Business Practice Location Address
First Line : 214 CORNELIA ST
Second Line : SUITE 203
City : PLATTSBURGH
State : NY
Zip : 12901-2317
Country : US
Telephone Number : 518-563-2404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 02/25/2017

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Directions to “ MS. MEGAN FORTTRELL BAKER PA” Practice Location

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