Edward V. Bauman, PSYD
Individual provider Active NPI Psychologist · Watertown, MA
NPI 1174575674 · NPPES record last updated Apr 7, 2009
Key facts
- NPI
- 1174575674
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 4799 (MA)
- Practice address
- 485 Arsenal St
Watertown, MA 02472-5091 - Phone
- (617) 972-5540
- NPI assigned
- May 16, 2006
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4799 | MA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4799 | MA | Yes |
Addresses
Primary practice location
485 Arsenal St
Watertown, MA 02472-5091
Mailing address
147 Milk St
Provider Enrollment 9TH Floor
Boston, MA 02109-4806
Phone (617) 559-8051
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 669499 | Other | MA | TUFTS HEALTH PLAN |
| W05832 | Other | MA | BLUE CROSS |
| 0014266 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
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- Leon B Bastajian
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- Mark R Bauer
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- Margaret Ann Beck
- Carol Becker
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All providers in Watertown, MA · Psychologist in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.