Provider Demographics
NPI:1922035062
Name:BAKER, TAMMY LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:BAKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 OLD YORK RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3800
Mailing Address - Country:US
Mailing Address - Phone:215-517-1000
Mailing Address - Fax:215-517-1049
Practice Address - Street 1:1235 OLD YORK RD
Practice Address - Street 2:SUITE 222
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3800
Practice Address - Country:US
Practice Address - Phone:215-517-1000
Practice Address - Fax:215-517-1049
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA051726363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ23167Medicare UPIN
PA097270Medicare ID - Type Unspecified