Provider Demographics
NPI:1861720021
Name:BAUMGARTEN, ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:BAUMGARTEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 LAMBERT RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-3008
Mailing Address - Country:US
Mailing Address - Phone:203-795-3357
Mailing Address - Fax:
Practice Address - Street 1:528 LAMBERT RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3008
Practice Address - Country:US
Practice Address - Phone:203-795-3357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT015363208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice