Provider Demographics
NPI:1780654897
Name:BAXTER, CLAUDIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:M
Last Name:BAXTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:120 PARK LANE RD
Mailing Address - Street 2:SUITE B-202
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-2444
Mailing Address - Country:US
Mailing Address - Phone:860-210-0082
Mailing Address - Fax:860-210-1633
Practice Address - Street 1:120 PARK LANE RD
Practice Address - Street 2:SUITE B-202
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2444
Practice Address - Country:US
Practice Address - Phone:860-210-0082
Practice Address - Fax:860-210-1633
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT042570174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001425702Medicaid
CTI18628Medicare UPIN