Provider Demographics
NPI:1144269911
Name:BAKER BREAST PROSTHESIS & SURGICAL STOCKINGS CORP.
Entity type:Organization
Organization Name:BAKER BREAST PROSTHESIS & SURGICAL STOCKINGS CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ETTY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-877-8860
Mailing Address - Street 1:145 W 71ST ST
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3802
Mailing Address - Country:US
Mailing Address - Phone:212-877-8860
Mailing Address - Fax:212-799-8356
Practice Address - Street 1:145 W 71ST ST
Practice Address - Street 2:SUITE 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3802
Practice Address - Country:US
Practice Address - Phone:212-877-8860
Practice Address - Fax:212-799-8356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY120423OtherAETNA
NYG71532OtherBLUE CROSS BLUE SHIELD
NY57C0601OtherCOMMUNITY PREMIER PLUS
NY040401001486OtherFIDELIS CARE OF NY
NY1000002744OtherAFFINITY HEALTH PLAN
NY2C3110OtherHEALTHNET
NY57P0471OtherCOMMUNITY HEALTH PLAN
NYA395883OtherOXFORD
NY01261343Medicaid
NY174138OtherELDERPLAN
NY1068780OtherUNITED HEALTHCARE
NY=========OtherMETRO PLUS HEALTH PLAN
NY174138OtherELDERPLAN
NY2C3110OtherHEALTHNET
NY=========001OtherHEALTHFIRST
NY01261343Medicaid
NY040401001486OtherFIDELIS CARE OF NY
NY57P0471OtherCOMMUNITY HEALTH PLAN
NYA395883OtherOXFORD