Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | ||
Y | 2251X0800X | Physical Therapist - Orthopedic | 010303 | CT |
N | 2251X0800X | Physical Therapist - Orthopedic | 037938-1 | NY |
NPI | 1497145536 |
---|---|
Provider Name | Dr. Tiffany Sudol Baker |
First Address | Wilton, CT 06897-3522 |
Second Address | Cos Cob, CT 06807-2533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2015 |
Last Update Date | 30/01/2021 |