| Lara Baskin PhD LLC | |
|
645 Westwood Ave Ste 206 River Vale NJ 07675-5300 | |
| (201) 735-2036 | |
| (201) 735-2036 |
| Full Name | Lara Baskin PhD LLC |
|---|---|
| Speciality | Psychologist |
| Location | 645 Westwood Ave Ste 206, River Vale, New Jersey |
| Authorized Official Name and Position | Lara E Baskin (OWNER MANAGING MEMBER) |
| Authorized Official Contact | 9172737896 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lara Baskin PhD LLC 521 Piermont Ave S Unit 506 River Vale NJ 07675-5720 Ph: (917) 273-7896 | Lara Baskin PhD LLC 645 Westwood Ave Ste 206 River Vale NJ 07675-5300 Ph: (201) 735-2036 |
| NPI Number | 1891417473 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 09/19/2022 |
| Certification Date | 09/19/2022 |
| Medicare PECOS PAC ID | 7012384407 |
|---|---|
| Medicare Enrollment ID | O20221027000794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891417473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (NU) | Primary |
| Provider Name | Lara E Baskin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922193630 PECOS PAC ID: 3678475803 Enrollment ID: I20040127000671 |
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