Baskerville, Renee E

Baskerville, Renee E is an individual health care provider with primary practice located at 90 Washington St Suite 209, East Orange NJ 07017. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Baskerville, Renee E can be contacted via phone (973) 677-1551.

Contact Information

Primary practice address
90 Washington St Suite 209 East Orange NJ 07017
Phone: (973) 677-1551
Fax: (973) 509-2658
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X MA50489 New Jersey

Profile Details

NPI number 1376769372
LBN Legal business name Baskerville, Renee E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376769372 NPPES
New Jersey MEDICAID 2016907

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