Provider Demographics
NPI:1881917631
Name:BAKER, STUART LEE (RP)
Entity type:Individual
Prefix:MR
First Name:STUART
Middle Name:LEE
Last Name:BAKER
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38-42 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:NJ
Mailing Address - Zip Code:07461-2331
Mailing Address - Country:US
Mailing Address - Phone:973-875-4141
Mailing Address - Fax:976-875-0529
Practice Address - Street 1:38-42 MAIN ST
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:NJ
Practice Address - Zip Code:07461-2331
Practice Address - Country:US
Practice Address - Phone:973-875-4141
Practice Address - Fax:973-875-0529
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R101251000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist