Provider Demographics
NPI:1508890864
Name:BAUM, RAYMOND I (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:BAUM
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:445 BRICK BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6079
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 206
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA056298002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E91202Medicare UPIN