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NPI Code Detail

MEDICARE: DR. TAMARA MARIE BAUM M.D.

MEDICARE: DR. TAMARA MARIE BAUM M.D.
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
12085R0202XDiagnostic Radiology PhysicianMD453089PA
2207T00000XNeurological Surgery PhysicianMT200298PA
32085R0202XDiagnostic Radiology Physician34200101NY
4207T00000XNeurological Surgery PhysicianMD453089PA
52085R0204XVascular & Interventional Radiology Physician34200101NY
62085R0204XVascular & Interventional Radiology PhysicianMD453089PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255619854
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAMARA MARIE BAUM M.D.
Provider Business Mailing Address
First Line : 110 LAMB TAVERN LN
Second Line :
City : GLENMOORE
State : PA
Zip : 19343-1818
Country : US
Telephone Number : 617-763-6896
Fax Number :
Provider Business Practice Location Address
First Line : 100 WOODS RD
Second Line :
City : VALHALLA
State : NY
Zip : 10595-1530
Country : US
Telephone Number : 914-231-8373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2011
Last Update Date : 06/02/2026

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