MEDICARE: MR. SHLOMO BAUMAN FNP

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	363LF0000X	Family Nurse Practitioner	F349130-01	NY
2	171M00000X	Case Manager/Care Coordinator
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F407701-01	NY

General Provider Information

NPI Number	:	1669839031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHLOMO BAUMAN FNP

Provider Business Mailing Address
First Line	:	1569 E 35TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3438
Country	:	US
Telephone Number	:	908-910-1888
Fax Number	:

Provider Business Practice Location Address
First Line	:	1811 AVENUE J
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-3808
Country	:	US
Telephone Number	:	929-263-2938
Fax Number	:

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

Provider Enumeration Date	:	01/15/2016
Last Update Date	:	12/08/2025

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