Provider Demographics
NPI:1285816819
Name:PAUL H BAUMGARTEN DPM
Entity Type:Organization
Organization Name:PAUL H BAUMGARTEN DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAUMGARTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:518-346-6000
Mailing Address - Street 1:1344 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-3018
Mailing Address - Country:US
Mailing Address - Phone:518-346-6000
Mailing Address - Fax:
Practice Address - Street 1:302 GENESEE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4618
Practice Address - Country:US
Practice Address - Phone:315-733-2347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAUL H BAUMGARTEN DPM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0665360001Medicare NSC