Provider Demographics
NPI:1932411857
Name:BASENESE, ANITA MARIE (RN, NP, APN-C)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:MARIE
Last Name:BASENESE
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Gender:F
Credentials:RN, NP, APN-C
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Mailing Address - Street 1:629 CRANBURY RD FL 2
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4096
Mailing Address - Country:US
Mailing Address - Phone:732-390-7750
Mailing Address - Fax:732-390-7725
Practice Address - Street 1:629 CRANBURY RD FL 2
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4096
Practice Address - Country:US
Practice Address - Phone:732-390-7750
Practice Address - Fax:732-390-7725
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2023-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NO0011435800363L00000X
NY545216-1363L00000X
NJ26NJ00169700363L00000X
NYF440016-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner