Basic Information
| Provider Information | |||||||||
| NPI: | 1669581807 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAKER | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | PAMELA | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSN, FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17 GLENN POND ROAD | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | RED HOOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125711824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457586046 | ||||||||
| FaxNumber: | 8457586051 | ||||||||
| Practice Location | |||||||||
| Address1: | 17 GLENN POND ROAD | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | RED HOOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125711824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457586046 | ||||||||
| FaxNumber: | 8457586051 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 08/29/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F-331519-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | A400024062 | 01 | NY | DOWNSTATE MEDICARE PIN | OTHER | J400013780 | 01 | NY | UPSTATE MEDICARE PIN | OTHER | 02251949 | 05 | NY | MEDICAID |