Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 109278 | NY |
NPI | 1033110960 |
---|---|
Provider Name | Dr. Stephen Robert Baumgarten |
First Address | Brooklyn, NY 11229-3149 |
Second Address | Brooklyn, NY 11229-3149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 26/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00258186 | (05) | NY |
B12660 | (02) | NY |