Provider Demographics
NPI:1396823506
Name:BAUMAN, JONATHAN HUGH (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:HUGH
Last Name:BAUMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 ROUTE 6
Mailing Address - Street 2:PUTNAM FAMILY & COMMUNITY SERVICES
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512
Mailing Address - Country:US
Mailing Address - Phone:845-225-2700
Mailing Address - Fax:845-225-3207
Practice Address - Street 1:1808 ROUTE 6
Practice Address - Street 2:PUTNAM FAMILY & COMMUNITY SERVICES
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512
Practice Address - Country:US
Practice Address - Phone:845-225-2700
Practice Address - Fax:845-225-3207
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1583442084P0800X
CT0351532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY68D342Medicare ID - Type Unspecified
NYA63780Medicare UPIN