Provider Demographics
NPI:1649416819
Name:BAUM- KUPFER, DEBORA (PT)
Entity Type:Individual
Prefix:MRS
First Name:DEBORA
Middle Name:
Last Name:BAUM- KUPFER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 DINEV CT
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-6326
Mailing Address - Country:US
Mailing Address - Phone:845-782-7510
Mailing Address - Fax:
Practice Address - Street 1:6 DINEV CT
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-6326
Practice Address - Country:US
Practice Address - Phone:845-782-7510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008167-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics