Provider Demographics
NPI:1629010764
Name:BAUMAN, RICHARD ALAN (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALAN
Last Name:BAUMAN
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8285 JERICHO TPKE
Mailing Address - Street 2:OPTICS PLUS
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1807
Mailing Address - Country:US
Mailing Address - Phone:516-367-2020
Mailing Address - Fax:516-367-3379
Practice Address - Street 1:8285 JERICHO TPKE
Practice Address - Street 2:OPTICS PLUS
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1807
Practice Address - Country:US
Practice Address - Phone:516-367-2020
Practice Address - Fax:516-367-3379
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004024156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician