Provider Demographics
NPI:1003261504
Name:NATASHA G BARON
Entity Type:Organization
Organization Name:NATASHA G BARON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:G
Authorized Official - Last Name:BARON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-334-2537
Mailing Address - Street 1:12-15 BROADWAY
Mailing Address - Street 2:2A
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-2031
Mailing Address - Country:US
Mailing Address - Phone:201-334-2537
Mailing Address - Fax:
Practice Address - Street 1:12-15 BROADWAY
Practice Address - Street 2:2A
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-2031
Practice Address - Country:US
Practice Address - Phone:201-334-2537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA090592002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty