Provider Demographics
NPI:1033217153
Name:STUART BASKIN, M.D., P.A.
Entity Type:Organization
Organization Name:STUART BASKIN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:E
Authorized Official - Last Name:BASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-218-1800
Mailing Address - Street 1:225 MILLBURN AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1737
Mailing Address - Country:US
Mailing Address - Phone:973-218-1800
Mailing Address - Fax:973-218-1801
Practice Address - Street 1:225 MILLBURN AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1737
Practice Address - Country:US
Practice Address - Phone:973-218-1800
Practice Address - Fax:973-218-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA22828207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2728001Medicaid
NJ2728001Medicaid