Individual
MR. RYAN EDWARD BAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPAC
Contact information
Practice address
60 E INDUSTRY CT, DEER PARK, NY 11729-4728
(631) 667-0222
(631) 667-0223
Mailing address
60 EAST INDUSTRY COURT, DEER PARK, NY 11729
(631) 667-0222
(631) 667-0223
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
015345
NY
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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