Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | SC004683L | PA |
N | 222Z00000X | Podiatrist | SC004683L | PA |
Y | 213ES0131X | Foot Surgery | SC004683L | PA |
NPI | 1235114331 |
---|---|
Provider Name | Lora Baker |
First Address | Allentown, PA 18104-1326 |
Second Address | Allentown, PA 18104-1326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2005 |
Last Update Date | 17/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U90706 | (02) | PA |