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NPI Code Detail

MEDICARE: DR. EARLE E BAIN M.D.

MEDICARE: DR. EARLE E BAIN 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
12084P0800XPsychiatry Physician159311MA

General Provider Information

NPI Number : 1619943065
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EARLE E BAIN M.D.
Provider Business Mailing Address
First Line : 26102 CHERRY BLOSSOM CT
Second Line :
City : LAWRENCEVILLE
State : NJ
Zip : 08648-1281
Country : US
Telephone Number : 609-799-9374
Fax Number : 609-730-3125
Provider Business Practice Location Address
First Line : 1125 TRENTON HARBOURTON RD
Second Line :
City : TITUSVILLE
State : NJ
Zip : 08560-1504
Country : US
Telephone Number : 609-730-4346
Fax Number : 609-730-3125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2006
Last Update Date : 07/08/2007

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Directions to “ DR. EARLE E BAIN M.D.” Practice Location

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