Provider Demographics
NPI:1417002858
Name:BAUMAN AND STOLERU MDPC
Entity Type:Organization
Organization Name:BAUMAN AND STOLERU MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROSENSTADT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-387-8900
Mailing Address - Street 1:3553 16TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3041
Mailing Address - Country:US
Mailing Address - Phone:202-387-8900
Mailing Address - Fax:202-328-0565
Practice Address - Street 1:4119 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1155
Practice Address - Country:US
Practice Address - Phone:202-966-4008
Practice Address - Fax:202-328-0565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC022453100Medicaid
DC022453400Medicaid
DC022453100Medicaid
DC171071Medicare PIN