Provider Demographics
NPI:1306238886
Name:BAKER-JUD, DANIEL (OTR)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BAKER-JUD
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 E 63RD ST
Mailing Address - Street 2:APT. 34N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7919
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:504 E 63RD ST
Practice Address - Street 2:APT. 34N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7919
Practice Address - Country:US
Practice Address - Phone:415-419-6046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019337225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist