Provider Demographics
NPI:1194173245
Name:BAKER, ARIELLE (LSW)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:BAKER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:ARIELLE
Other - Middle Name:
Other - Last Name:SHEINMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1550 HARBOR BLVD
Mailing Address - Street 2:UNIT 2529
Mailing Address - City:WEEHAWKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07086-6875
Mailing Address - Country:US
Mailing Address - Phone:845-517-7308
Mailing Address - Fax:
Practice Address - Street 1:1550 HARBOR BLVD
Practice Address - Street 2:UNIT 2529
Practice Address - City:WEEHAWKEN
Practice Address - State:NJ
Practice Address - Zip Code:07086-6875
Practice Address - Country:US
Practice Address - Phone:845-517-7308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY17Medicaid