Provider Demographics
NPI:1346229598
Name:BAHLER, EMILY S (DO)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:S
Last Name:BAHLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S ORANGE AVE STE 12
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5817
Mailing Address - Country:US
Mailing Address - Phone:973-322-7636
Mailing Address - Fax:973-322-7673
Practice Address - Street 1:200 S ORANGE AVE STE 12
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5817
Practice Address - Country:US
Practice Address - Phone:973-322-7636
Practice Address - Fax:973-322-7673
Is Sole Proprietor?:No
Enumeration Date:2006-01-14
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07573700207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
078608Medicare ID - Type Unspecified
I05434Medicare UPIN