NPI 1295373785 · live from the CMS NPI Registry
Jeremy Ronald Baker, PA
Physician Assistant, Medical in Hartford, CT. National Provider Identifier 1295373785, active.
NPI record
| NPI | 1295373785 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 19 Woodland St Ste 23, Hartford, CT 06105 |
| Practice phone | 860-522-2251 |
| Mailing address | 189 Kearsarge Valley Rd, Wilmot, NH 03287 |
| Enumerated | December 15, 2019 |
| Last updated | May 12, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Physician Assistant, Medical primary | 363AM0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.