Provider Demographics
NPI:1881738755
Name:YELENA LINDEN BAUM MEDICAL PC
Entity type:Organization
Organization Name:YELENA LINDEN BAUM MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-823-7138
Mailing Address - Street 1:1623 3RD AVE
Mailing Address - Street 2:9J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3638
Mailing Address - Country:US
Mailing Address - Phone:646-823-7138
Mailing Address - Fax:
Practice Address - Street 1:314 W 14TH ST
Practice Address - Street 2:6 FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-5002
Practice Address - Country:US
Practice Address - Phone:646-823-7138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2074082084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWU3681Medicare ID - Type Unspecified
NYH01731Medicare UPIN