Provider Demographics
NPI:1649681107
Name:BAKER, AMBRIA
Entity type:Individual
Prefix:MS
First Name:AMBRIA
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 MADISON AVE
Mailing Address - Street 2:APT9F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-2812
Mailing Address - Country:US
Mailing Address - Phone:646-228-0032
Mailing Address - Fax:
Practice Address - Street 1:4004 10TH ST APT 3B
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-6424
Practice Address - Country:US
Practice Address - Phone:646-228-0032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-17
Last Update Date:2014-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program