Provider Demographics
NPI:1174052922
Name:BAKER, PAMELA SUSAN (MSW)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:SUSAN
Last Name:BAKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 673
Mailing Address - Street 2:
Mailing Address - City:NEW HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:10958-0673
Mailing Address - Country:US
Mailing Address - Phone:845-239-4037
Mailing Address - Fax:
Practice Address - Street 1:400 GIDNEY AVE
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3760
Practice Address - Country:US
Practice Address - Phone:845-565-4345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker