Provider Demographics
NPI:1275759508
Name:BAUER, ARNOLD MARTIN (RP)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:MARTIN
Last Name:BAUER
Suffix:
Gender:M
Credentials:RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 LEONARD TER
Mailing Address - Street 2:
Mailing Address - City:ROSELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07068-3720
Mailing Address - Country:US
Mailing Address - Phone:973-364-0083
Mailing Address - Fax:973-287-6376
Practice Address - Street 1:45 LEONARD TER
Practice Address - Street 2:
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-3720
Practice Address - Country:US
Practice Address - Phone:973-635-0083
Practice Address - Fax:973-635-0080
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28R101012500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist