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Individual

DR. STEPHEN MARC BAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
608 PEARL ST, WATERTOWN, NY 13601-2194
(315) 788-2020
(315) 755-3937
Mailing address
608 PEARL STREET, WATERTOWN, NY 13061
(315) 788-2020
(315) 755-3937

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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