Provider Demographics
NPI:1639153943
Name:BAKER, TRUDY REID (MD)
Entity Type:Individual
Prefix:DR
First Name:TRUDY
Middle Name:REID
Last Name:BAKER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:908 NIAGARA FALLS BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-2160
Mailing Address - Fax:716-692-4342
Practice Address - Street 1:3085 HARLEM RD
Practice Address - Street 2:STE 300
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2591
Practice Address - Country:US
Practice Address - Phone:716-422-5422
Practice Address - Fax:716-422-5420
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2017-02-08
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Provider Licenses
StateLicense IDTaxonomies
NY1492771207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00834217Medicaid
NY00834217Medicaid
14428AMedicare PIN
NY1477619732OtherPRACTICE NPI