Provider Demographics
NPI:1568517951
Name:BARE, JAMES STANTON (LAC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:STANTON
Last Name:BARE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SMALLWOOD PL
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-2311
Mailing Address - Country:US
Mailing Address - Phone:914-428-9215
Mailing Address - Fax:
Practice Address - Street 1:600 N BROADWAY
Practice Address - Street 2:SUITE 207
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-2466
Practice Address - Country:US
Practice Address - Phone:914-661-3072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001157171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist