Provider Demographics
NPI:1598065187
Name:BAUM, RICARDA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDA
Middle Name:LOUISE
Last Name:BAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 E 84TH ST
Mailing Address - Street 2:SUITE 5B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6226
Mailing Address - Country:US
Mailing Address - Phone:212-734-9580
Mailing Address - Fax:
Practice Address - Street 1:444 E 84TH ST
Practice Address - Street 2:SUITE 5B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-6226
Practice Address - Country:US
Practice Address - Phone:212-734-9580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY110340208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics