Provider Demographics
NPI:1508921982
Name:BAUMLER, GREGORY NATHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:NATHAN
Last Name:BAUMLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:398A EVANS SREET
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3573
Mailing Address - Country:US
Mailing Address - Phone:716-632-2200
Mailing Address - Fax:
Practice Address - Street 1:398A EVANS ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-3573
Practice Address - Country:US
Practice Address - Phone:716-632-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011069111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY204389345OtherPRISM
NY8891099OtherINDEPENDENT HEALTH
NYIA0856Medicare ID - Type Unspecified