Provider Demographics
NPI:1205010279
Name:BARON, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:BARON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 MORRIS LN
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1706
Mailing Address - Country:US
Mailing Address - Phone:516-305-4799
Mailing Address - Fax:
Practice Address - Street 1:1345 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4403
Practice Address - Country:US
Practice Address - Phone:212-535-9816
Practice Address - Fax:212-535-9863
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047259183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist