Individual
SHAYAMALA BASKARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Mailing address
150 FLORAL AVE, NEW PROVIDENCE, NJ 07974-1557
(908) 273-4300
(908) 790-6576
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00294600
NJ
Other
Enumeration date
11/19/2008
Last updated
10/11/2016
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