MEDICARE: MS. JESSICA BAUMAN OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	031091	NY

General Provider Information

NPI Number	:	1639012719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JESSICA BAUMAN OTR/L

Provider Business Mailing Address
First Line	:	6 ANNA MARIA CT
Second Line	:
City	:	FISHKILL
State	:	NY
Zip	:	12524-2845
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	696 DUTCHESS TPKE STE C
Second Line	:
City	:	POUGHKEEPSIE
State	:	NY
Zip	:	12603-6445
Country	:	US
Telephone Number	:	845-202-0157
Fax Number	:	845-249-2496

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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