Provider Demographics
NPI:1801976469
Name:BAKER, SYDNEY T (PA)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:T
Last Name:BAKER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 MACON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-1517
Mailing Address - Country:US
Mailing Address - Phone:347-350-8581
Mailing Address - Fax:
Practice Address - Street 1:506 SIXTH STREET
Practice Address - Street 2:NEW YORK METHODIST HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-9008
Practice Address - Country:US
Practice Address - Phone:718-780-5942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005087363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant