Provider Demographics
NPI:1740335132
Name:BAUMAN, KAREN J (MA, CCC-A)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 KARIN STREET
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360
Mailing Address - Country:US
Mailing Address - Phone:856-205-1009
Mailing Address - Fax:856-205-0496
Practice Address - Street 1:1180 KARIN STREET
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360
Practice Address - Country:US
Practice Address - Phone:856-205-1009
Practice Address - Fax:856-205-0496
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00026100231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6839801Medicaid
R91103Medicare UPIN
SO220607Medicare ID - Type Unspecified