Provider Demographics
NPI:1467536789
Name:BAUER, STEPHEN F (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:F
Last Name:BAUER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:134 E 93RD ST
Mailing Address - Street 2:12A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1635
Mailing Address - Country:US
Mailing Address - Phone:212-410-2094
Mailing Address - Fax:212-410-2094
Practice Address - Street 1:134 E 93RD ST
Practice Address - Street 2:12A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1635
Practice Address - Country:US
Practice Address - Phone:212-410-2094
Practice Address - Fax:212-410-2094
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY077991-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY196861Medicare ID - Type Unspecified
NYC-06639Medicare UPIN