Provider Demographics
NPI:1114393824
Name:BAUMAN, NAOMI (PSYD)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12-33 SCRIBNER RD
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-4243
Mailing Address - Country:US
Mailing Address - Phone:203-489-6641
Mailing Address - Fax:
Practice Address - Street 1:12-33 SCRIBNER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-4243
Practice Address - Country:US
Practice Address - Phone:203-489-6641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023888103TC2200X
NJ35SI00643400103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent