Provider Demographics
NPI:1669564589
Name:BAKER, CARYN LINDSAY (PT ATC)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:LINDSAY
Last Name:BAKER
Suffix:
Gender:F
Credentials:PT ATC
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:FRANCES
Other - Last Name:LINDSAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SOLVAY
Mailing Address - State:NY
Mailing Address - Zip Code:13209
Mailing Address - Country:US
Mailing Address - Phone:315-484-9447
Mailing Address - Fax:
Practice Address - Street 1:315 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:SOLVAY
Practice Address - State:NY
Practice Address - Zip Code:13209
Practice Address - Country:US
Practice Address - Phone:315-484-9447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0256221225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA8993Medicare ID - Type Unspecified