Provider Demographics
NPI:1356387674
Name:BAKER, ROBERT DANIEL (PT, DSC, ECS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DANIEL
Last Name:BAKER
Suffix:
Gender:M
Credentials:PT, DSC, ECS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 PEBBLE CT
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1083
Mailing Address - Country:US
Mailing Address - Phone:412-787-3293
Mailing Address - Fax:412-787-1821
Practice Address - Street 1:24 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-1280
Practice Address - Country:US
Practice Address - Phone:412-787-3293
Practice Address - Fax:412-787-1821
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT000789E2251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001572155Medicaid
PA434798OtherHIGHMARK
PA0606178OtherAETNA USHEALTHCARE
PAS41588Medicare UPIN
PA001572155Medicaid