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Individual
MS. TRACILYN BAUN
Active
Individual
MS. TRACILYN BAUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00566800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2369948000
AMERIHEALTH
NJ
01
—
P00216846
RAILROAD MCR
NJ
Enumeration date
12/11/2006
Last updated
04/26/2012
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