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1750977260 NPI number — AMY BAUMBACH BAILAS RPH

NPI Number: 1750977260
Health Care Provider/Practitioner: AMY BAUMBACH BAILAS RPH

Information about “1750977260” NPI (AMY BAUMBACH BAILAS RPH) exists in 1750977260 in HTML format HTML  |  1750977260 in plain Text format TXT  |  1750977260 in PDF (Portable Document Format) PDF  |  1750977260 in an XML format XML  formats.

NPI Number : 1750977260 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750977260",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BAILAS",
    "FirstName": "AMY",
    "MiddleName": "BAUMBACH",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "RPH",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "BAUMBACH",
    "OtherFirstName": "AMY",
    "OtherMiddleName": "JO",
    "OtherNamePrefix": "MS.",
    "OtherNameSuffix": null,
    "OtherCredential": "RPH",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "38 MARSH RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EASTON",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06612-1927",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "203-615-8678",
    "MailingAddressFaxNumber": "646-441-4683",
    "FirstLinePracticeLocationAddress": "38 MARSH RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EASTON",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06612-1927",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "203-615-8678",
    "PracticeLocationAddressFaxNumber": "646-441-4683",
    "EnumerationDate": "12/18/2020",
    "LastUpdateDate": "12/18/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "07281",
        "LicenseNumberStateCode": "CT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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