Individual
DR. STEPHEN MARC BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV-006508
NY
152WL0500X
Low Vision Rehabilitation Optometrist
TUV-006508
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02399159
—
NY
01
—
P00364925
PALMETTO GBA-RR MC
NY
01
—
P00381537
PALMETTO GBA-RR MC
NY
Enumeration date
10/02/2006
Last updated
07/21/2022
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