Provider Demographics
NPI:1821399833
Name:BAUER, KAREN LYNETTE (MS, LAC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LYNETTE
Last Name:BAUER
Suffix:
Gender:F
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 6TH AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-5492
Mailing Address - Country:US
Mailing Address - Phone:201-788-4098
Mailing Address - Fax:
Practice Address - Street 1:1026 6TH AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-5492
Practice Address - Country:US
Practice Address - Phone:201-788-4098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-07
Last Update Date:2010-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004412171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist