DR. LARA ELIZABETH BASKIN PH.D.
Clinical Neuropsychologist
Englewood, New Jersey
Provider NPI: 1922193630
Provider Information:DR. LARA ELIZABETH BASKIN PH.D.
Gender: F
Sole Proprietor
Practice Location:
25 ROCKWOOD PL FIRST FLOOR ENGLEWOOD, NJ 07631 US
Tel: 201-735-2036 Fax: --
Business Mailing Address:
2 HORIZON RD SUITE 1425 FORT LEE, NJ 07024 US
Tel: -- Fax: --
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | NY | 012492 |
N | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | NJ | SI 03629 |
N | 103TC0700X | Behavioral Health & Social Service Providers Psychologist | NY | 012492 |
Y | 103TC0700X | Behavioral Health & Social Service Providers Psychologist | NJ | SI 03629 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
EMPIRE BCBS OUT-NETWORK | V8274 | NY | 01 |
OXFORD OUT-OF-NETWORK ID | P2347822 | NJ | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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