Provider Demographics
NPI:1942630884
Name:DR. MELVA L. BAKER PODIATRY, PC
Entity Type:Organization
Organization Name:DR. MELVA L. BAKER PODIATRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:646-345-1253
Mailing Address - Street 1:159 E 103RD ST
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5341
Mailing Address - Country:US
Mailing Address - Phone:646-345-1253
Mailing Address - Fax:
Practice Address - Street 1:928 BROADWAY STE 904
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8120
Practice Address - Country:US
Practice Address - Phone:646-783-9491
Practice Address - Fax:212-369-7850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00637213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty