Russell William Bauer

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Sayre, PA

NPI 1104769231 · NPPES record last updated Apr 13, 2026

Key facts

NPI
1104769231
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1 Guthrie SQ
Sayre, PA 18840-1625
Phone
(570) 888-6666
NPI assigned
Apr 13, 2026
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PA Yes

Addresses

Primary practice location

1 Guthrie SQ
Sayre, PA 18840-1625

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-6666

Other providers in Sayre, PA

All providers in Sayre, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania

Sources for this page

Verify at the official NPI Registry.