Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CO-2608-OB | NY |
NPI | 1013002062 |
---|---|
Provider Name | Dr. Scott Paul Bauman |
First Address | East Northport, NY 11731-4205 |
Second Address | East Northport, NY 11731-4205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |