Provider Demographics
NPI:1235259201
Name:BAUER, KARL J (DC)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:J
Last Name:BAUER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 BROADWAY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-8154
Mailing Address - Country:US
Mailing Address - Phone:212-686-2244
Mailing Address - Fax:212-686-6275
Practice Address - Street 1:928 BROADWAY
Practice Address - Street 2:SUITE 304
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8154
Practice Address - Country:US
Practice Address - Phone:212-686-2244
Practice Address - Fax:212-686-6275
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009529111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician