Basic Information
Provider Information
NPI: 1275531493
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAER
FirstName: JAMES
MiddleName: ROBERT
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: ELM AND CARLTON ST
Address2:  
City: BUFFALO
State: NY
PostalCode: 142630001
CountryCode: US
TelephoneNumber: 7168452300
FaxNumber: 7168457616
Practice Location
Address1: 515 MAIN ST
Address2:  
City: OLEAN
State: NY
PostalCode: 147601513
CountryCode: US
TelephoneNumber: 7163732600
FaxNumber: 7163735187
Other Information
ProviderEnumerationDate: 07/12/2005
LastUpdateDate: 06/30/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0001X275657NYY Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology

No ID Information.


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