Provider Demographics
NPI:1447919279
Name:BAKER, PATRICIA L
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:L
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 1:134 GREEN FOREST DR
Mailing Address - Street 2:
Mailing Address - City:BADEN
Mailing Address - State:PA
Mailing Address - Zip Code:15005-9619
Mailing Address - Country:US
Mailing Address - Phone:412-496-7939
Mailing Address - Fax:
Practice Address - Street 1:2500 LOVI RD
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:15042-9398
Practice Address - Country:US
Practice Address - Phone:724-683-3710
Practice Address - Fax:724-683-3711
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP031979L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist