Individual
NICHOLAS G BARANETSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
268 DR MARTIN LUTHER KING JR BLVD STE B, NEWARK, NJ 07102-2011
(973) 877-5185
Mailing address
PO BOX 298, LIVINGSTON, NJ 07039
(973) 877-5185
(973) 877-5210
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MA046790
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1080709
—
NJ
01
—
28530
AETNA
—
01
—
E5102
OXFORD
—
Enumeration date
10/02/2006
Last updated
03/30/2021
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