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Individual
TRACY K BAUER
Active
Individual
TRACY K BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0057091
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000570180003
BCBS
NY
01
—
0400501003374
FIDELIS
NY
01
—
11563494
CAQH
NY
01
—
177013BJ
PREFERRED CARE
NY
01
—
9513165
IHA
NY
01
—
P001890577
MEDICARE RAILROAD
NY
Enumeration date
05/03/2006
Last updated
12/04/2021
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