Provider Demographics
NPI:1801014667
Name:BAUMLER, BENJAMIN RONALD (PT)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:RONALD
Last Name:BAUMLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:NY
Mailing Address - Zip Code:14081-9706
Mailing Address - Country:US
Mailing Address - Phone:716-951-7270
Mailing Address - Fax:716-951-7271
Practice Address - Street 1:845 MAIN RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:NY
Practice Address - Zip Code:14081-9706
Practice Address - Country:US
Practice Address - Phone:716-951-7270
Practice Address - Fax:716-951-7271
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0185371225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist