Provider Demographics
NPI:1225281439
Name:BAER, JESSICA ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ELLEN
Last Name:BAER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 WATER ST
Mailing Address - Street 2:5A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1056
Mailing Address - Country:US
Mailing Address - Phone:770-855-6877
Mailing Address - Fax:
Practice Address - Street 1:133 WATER ST
Practice Address - Street 2:5A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1056
Practice Address - Country:US
Practice Address - Phone:770-855-6877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY269506-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology