Provider Demographics
NPI:1306038963
Name:BAUMGARTEN, VICTOR A (PHD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:A
Last Name:BAUMGARTEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 9 BOX 2884
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09123-0029
Mailing Address - Country:US
Mailing Address - Phone:0656-561-8285
Mailing Address - Fax:
Practice Address - Street 1:PSC 9 BOX 2884
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09123-0029
Practice Address - Country:US
Practice Address - Phone:0656-561-8285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT280654-35011041C0700X
GACSW0026531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical