Provider Demographics
NPI:1326134743
Name:BAUN, CAROLINA CELIS (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:CELIS
Last Name:BAUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8837 FRANCIS LEWIS BLVD
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2243
Mailing Address - Country:US
Mailing Address - Phone:718-479-3700
Mailing Address - Fax:
Practice Address - Street 1:8837 FRANCIS LEWIS BLVD
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2243
Practice Address - Country:US
Practice Address - Phone:718-479-3700
Practice Address - Fax:718-776-5206
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY151868208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00810339Medicaid
NY151868OtherLICENSE