Provider Demographics
NPI:1679620009
Name:DR CHRISTINE J BAUER
Entity Type:Organization
Organization Name:DR CHRISTINE J BAUER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:JUDITH
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DC,LAC
Authorized Official - Phone:516-333-7770
Mailing Address - Street 1:401 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1222
Mailing Address - Country:US
Mailing Address - Phone:516-333-7770
Mailing Address - Fax:
Practice Address - Street 1:401 FULTON ST
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-1222
Practice Address - Country:US
Practice Address - Phone:516-333-7770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYXOO4598 1111N00000X
NY001796 1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0818375OtherAETNA#
NY4377064OtherCIGNA#
NYNYO4598OtherLANDMARK#
NY23451OtherGHI#
NYX28991OtherEMPIRE BC BS
NY130626OtherUNITEDHC#
NYP653908OtherOXFORD#
NY321095OtherACN MPN#
NY130626OtherUNITEDHC#