Provider Demographics
NPI:1023349289
Name:VASSILEV-BAKER, MARIA E (LAC)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:E
Last Name:VASSILEV-BAKER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 STATE RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1400
Mailing Address - Country:US
Mailing Address - Phone:609-924-4910
Mailing Address - Fax:
Practice Address - Street 1:812 STATE RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1400
Practice Address - Country:US
Practice Address - Phone:609-924-4910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00018900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist