Basic Information
Provider Information
NPI: 1952508681
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAUER
FirstName: KRISTY
MiddleName: LYN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SALADINO
OtherFirstName: KRISTY
OtherMiddleName: LYN
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 20 GRAND ST
Address2: 3RD FLOOR
City: WARWICK
State: NY
PostalCode: 109901035
CountryCode: US
TelephoneNumber: 8459873952
FaxNumber: 8459875979
Practice Location
Address1: 2 CROSFIELD AVE
Address2: SUITE 318
City: WEST NYACK
State: NY
PostalCode: 109942226
CountryCode: US
TelephoneNumber: 8453535600
FaxNumber: 8453535668
Other Information
ProviderEnumerationDate: 06/27/2007
LastUpdateDate: 09/05/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001X244584NYY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207R00000X244584NYN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home