Basic Information
Provider Information | |||||||||
NPI: | 1619289295 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | LAWYER | ||||||||
FirstName: | ALLISON | ||||||||
MiddleName: | BAKER | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2527 CRANBERRY HWY | ||||||||
Address2: |   | ||||||||
City: | WAREHAM | ||||||||
State: | MA | ||||||||
PostalCode: | 025711046 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8008415200 | ||||||||
FaxNumber: | 5082731241 | ||||||||
Practice Location | |||||||||
Address1: | 1505 W SHERMAN AVE | ||||||||
Address2: |   | ||||||||
City: | VINELAND | ||||||||
State: | NJ | ||||||||
PostalCode: | 083607059 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8566417937 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/12/2010 | ||||||||
LastUpdateDate: | 07/21/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MT196957 | PA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   |
No ID Information.