Provider Demographics
NPI:1801805650
Name:BAKER, DANETTE MICHELE (AUD)
Entity type:Individual
Prefix:DR
First Name:DANETTE
Middle Name:MICHELE
Last Name:BAKER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:352 7TH AVE
Mailing Address - Street 2:SUITE 1002
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5012
Mailing Address - Country:US
Mailing Address - Phone:212-379-6596
Mailing Address - Fax:212-379-6598
Practice Address - Street 1:352 7TH AVE
Practice Address - Street 2:SUITE 1002
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5012
Practice Address - Country:US
Practice Address - Phone:212-379-6596
Practice Address - Fax:212-379-6598
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002458237600000X
NY14000038191237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ31944ZMedicare UPIN