MEDICARE: JOEL J BAUER MD

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	208C00000X	Colon & Rectal Surgery Physician	102125	NY

General Provider Information

NPI Number	:	1689642704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL J BAUER MD

Provider Business Mailing Address
First Line	:	25 EAST 69TH STREET
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-4925
Country	:	US
Telephone Number	:	212-517-8600
Fax Number	:	212-535-3717

Provider Business Practice Location Address
First Line	:	25 EAST 69TH STREET
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-4925
Country	:	US
Telephone Number	:	212-517-8600
Fax Number	:	212-535-3717

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	03/27/2008

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