Provider Demographics
NPI:1194159798
Name:BAUMGARTNER, LANCE M (DPT)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:M
Last Name:BAUMGARTNER
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:1377 MOTOR PKWY
Mailing Address - Street 2:STE 307
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:631-580-5222
Practice Address - Street 1:280 NEWTON SPARTA RD
Practice Address - Street 2:STE 8
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2775
Practice Address - Country:US
Practice Address - Phone:973-579-2957
Practice Address - Fax:973-579-3321
Is Sole Proprietor?:No
Enumeration Date:2013-08-30
Last Update Date:2018-01-29
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Provider Licenses
StateLicense IDTaxonomies
NJ40QA015156100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist