Provider Demographics
NPI:1497940050
Name:RAYMOND BAUM, MD, LLC
Entity Type:Organization
Organization Name:RAYMOND BAUM, MD, LLC
Other - Org Name:COMPLETE PSYCHIATRIC SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-903-7186
Mailing Address - Street 1:445 BRICK BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6048
Mailing Address - Country:US
Mailing Address - Phone:732-903-7186
Mailing Address - Fax:732-903-7187
Practice Address - Street 1:445 BRICK BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6048
Practice Address - Country:US
Practice Address - Phone:732-903-7186
Practice Address - Fax:732-903-7187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA056298002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E91202Medicare UPIN
678860Medicare PIN