Provider Demographics
NPI:1790780187
Name:BAUM, CAROL G (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:G
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 1:560 WHILE PLAINS RD.
Mailing Address - Street 2:SUITE 500 ENT AND ALLERGY ASSOCIATES LLP
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5112
Mailing Address - Country:US
Mailing Address - Phone:914-333-5801
Mailing Address - Fax:
Practice Address - Street 1:620 COLUMBUS AVE.
Practice Address - Street 2:2ND FLOOR ENT AND ALLERGY ASSOCIATES LLP,
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-600-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031162174400000X
NY158609207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01218139Medicaid
CT001311620Medicaid
NYA400036901Medicare PIN
CTA60775Medicare UPIN
NYA400036901Medicare PIN