Provider Demographics
NPI:1063529287
Name:BAUM, HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:BAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:476 BAY RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2702
Mailing Address - Country:US
Mailing Address - Phone:718-238-2661
Mailing Address - Fax:718-238-2664
Practice Address - Street 1:476 BAY RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2702
Practice Address - Country:US
Practice Address - Phone:718-238-2661
Practice Address - Fax:718-238-2664
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184624-1207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01851298Medicaid
NYG15645Medicare UPIN
NY01851298Medicaid