Tara Marie Baker, MS./ED.

Individual provider Active NPI Behavior Analyst · Malverne, NY

NPI 1992052252 · NPPES record last updated Aug 6, 2012

Key facts

NPI
1992052252
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
License
1702493 (NY)
Practice address
62 Doncaster Rd
Malverne, NY 11565-1015
Phone
(516) 792-6940
Fax
(631) 594-3604
NPI assigned
Aug 6, 2012
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

LicenseStateTypeSpecialty
1702493NYMDBehavioral Analyst

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1702493 NY Yes

Addresses

Primary practice location

62 Doncaster Rd
Malverne, NY 11565-1015

Mailing address

62 Doncaster Rd
Malverne, NY 11565-1015
Phone (516) 792-6940

Other identifiers

IdentifierTypeStateIssuer
1702493OtherNYEARLY INTERVENTION SERVICE PROVIDERS LICENSE/CERTIFICATION NUMBER

Other providers in Malverne, NY

All providers in Malverne, NY · Behavior Analyst in New York

Sources for this page

Verify at the official NPI Registry.