Provider Demographics
NPI:1487618625
Name:BAUMAN, DANIEL BENJAMIN (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BENJAMIN
Last Name:BAUMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 5TH AVE
Mailing Address - Street 2:SUITE 10M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-4512
Mailing Address - Country:US
Mailing Address - Phone:212-799-4668
Mailing Address - Fax:
Practice Address - Street 1:286 5TH AVE
Practice Address - Street 2:SUITE 10M
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-4512
Practice Address - Country:US
Practice Address - Phone:212-799-4668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2036642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG90847Medicare UPIN
NY70M081Medicare ID - Type Unspecified