Laura Theresa Baker
Individual provider Active NPI Specialist · Breezy Point, NY
NPI 1134533151 · NPPES record last updated Jun 18, 2014
Key facts
- NPI
- 1134533151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 968066999 (NY)
- Practice address
- 928 Bayside
Breezy Point, NY 11697-1136 - Phone
- (646) 372-1241
- NPI assigned
- Jun 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 968066999 | NY | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 968066999 | NY | Yes |
Addresses
Primary practice location
928 Bayside
Breezy Point, NY 11697-1136
Mailing address
928 Bayside
Breezy Point, NY 11697-1136
Phone (646) 372-1241
Other providers in Breezy Point, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.