Provider Demographics
NPI:1043240104
Name:BASKIN, STUART E (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:E
Last Name:BASKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E NORTHFIELD RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4896
Mailing Address - Country:US
Mailing Address - Phone:973-994-2121
Mailing Address - Fax:973-535-8191
Practice Address - Street 1:315 E NORTHFIELD RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4896
Practice Address - Country:US
Practice Address - Phone:973-994-2121
Practice Address - Fax:973-535-8191
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA22828207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2728001Medicaid
NJBA458726Medicare ID - Type Unspecified
NJ2728001Medicaid