Provider Demographics
NPI:1821102609
Name:BAKER, DONALD F (OD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:F
Last Name:BAKER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COLD HILL RD SOUTH BOX 250
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-0250
Mailing Address - Country:US
Mailing Address - Phone:973-543-6101
Mailing Address - Fax:973-543-4071
Practice Address - Street 1:5 COLD HILL RD S # 250
Practice Address - Street 2:SUITE 4
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-3230
Practice Address - Country:US
Practice Address - Phone:973-543-6101
Practice Address - Fax:973-543-4071
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00374900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1177303Medicaid
U12488Medicare UPIN
NJ0510410001Medicare NSC
NJ521330Medicare PIN