Healthcare Provider Details

I. General information

NPI: 1598335994
Provider Name (Legal Business Name): ERICA N BAUMER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 07/07/2023
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

74 DORIS RD
IRONDEQUOIT NY
14622-2508
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-9555
  • Fax: 585-473-3516
Mailing address:
  • Phone: 585-358-1690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number26901
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: