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Individual
LISA M BAUMAN
Active
Individual
LISA M BAUMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
015667
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03523939
—
NY
Enumeration date
06/28/2012
Last updated
01/07/2020
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