Provider Demographics
NPI:1285893388
Name:BARAM, DAMON WARREN (LAC/LMT)
Entity type:Individual
Prefix:MR
First Name:DAMON
Middle Name:WARREN
Last Name:BARAM
Suffix:
Gender:
Credentials:LAC/LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 W 71ST ST APT 2E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3546
Mailing Address - Country:US
Mailing Address - Phone:917-597-0678
Mailing Address - Fax:
Practice Address - Street 1:32 UNION SQ E STE 411
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3222
Practice Address - Country:US
Practice Address - Phone:212-539-1690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003195171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist