Individual
DR. KAITLAN BASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3 COOPER PLZ RM 220, CAMDEN, NJ 08103-1438
(856) 342-2439
Mailing address
1 FEDERAL ST STE SW200, CAMDEN, NJ 08103-1155
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA09783500
NJ
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
25MA09783500
NJ
Other
Enumeration date
06/17/2011
Last updated
12/14/2020
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