Provider Demographics
NPI:1396798773
Name:BAKER, WILLIAM ALFRED (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ALFRED
Last Name:BAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 COUNTY ROUTE 61
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12816-2504
Mailing Address - Country:US
Mailing Address - Phone:518-677-5492
Mailing Address - Fax:518-677-5492
Practice Address - Street 1:481 COUNTY ROUTE 61
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:12816-2504
Practice Address - Country:US
Practice Address - Phone:518-677-5492
Practice Address - Fax:518-677-5492
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159639207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00303822OtherMEDICARE RAILROAD
FL46282OtherBCBS
FL255999400Medicaid
NY00885396Medicaid
NYJ300193569Medicare UPIN
FL255999400Medicaid
FL46282OtherBCBS
FLE34080Medicare UPIN