Ryan Edward Baker, RPAC

Individual provider Active NPI Medical Physician Assistant · Deer Park, NY

NPI 1992077069 · NPPES record last updated Feb 3, 2012

Key facts

NPI
1992077069
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
015345 (NY)
Practice address
60 E Industry CT
Deer Park, NY 11729-4728
Phone
(631) 667-0222
Fax
(631) 667-0223
NPI assigned
Feb 3, 2012
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Edwardo M Yambo MD PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 015345 NY Yes

Addresses

Primary practice location

60 E Industry CT
Deer Park, NY 11729-4728

Mailing address

60 East Industry Court
Deer Park, NY 11729
Phone (631) 667-0222

Other providers in Deer Park, NY

All providers in Deer Park, NY · Medical Physician Assistant in New York

Sources for this page

Verify at the official NPI Registry.