Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | X009529 | NY |
NPI | 1235259201 |
---|---|
Provider Name | Dr. Karl J Bauer |
First Address | New York, NY 10010-8154 |
Second Address | New York, NY 10010-8154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2007 |
Last Update Date | 19/08/2009 |