Provider Demographics
NPI:1780606939
Name:BAUMAN, JAY M (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:M
Last Name:BAUMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 E 90TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0654
Mailing Address - Country:US
Mailing Address - Phone:212-410-7400
Mailing Address - Fax:212-410-7410
Practice Address - Street 1:21 E 90TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0654
Practice Address - Country:US
Practice Address - Phone:212-410-7400
Practice Address - Fax:212-410-7410
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158829207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA64036Medicare UPIN
NY73D031Medicare ID - Type Unspecified