Provider Demographics
NPI:1104654813
Name:BAUMAN, ELIANA (PHD)
Entity type:Individual
Prefix:DR
First Name:ELIANA
Middle Name:
Last Name:BAUMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-0139
Mailing Address - Country:US
Mailing Address - Phone:410-245-9192
Mailing Address - Fax:
Practice Address - Street 1:66 W MOUNT PLEASANT AVE STE 206
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-2930
Practice Address - Country:US
Practice Address - Phone:845-605-2737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00748100103TC0700X
NY025325103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical