Individual
DR. LARA ELIZABETH BASKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
25 ROCKWOOD PL, FIRST FLOOR, ENGLEWOOD, NJ 07631-4957
(201) 735-2036
Mailing address
521 PIERMONT AVE S, UNIT 506, RIVER VALE, NJ 07675-5720
(917) 273-7896
(201) 735-2036
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
012492
NY
103G00000X
Clinical Neuropsychologist
SI 03629
NJ
103TC0700X
Clinical Psychologist
012492
NY
103TC0700X
Clinical Psychologist
Primary
SI 03629
NJ
103TC0700X
Clinical Psychologist
SI03629
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P2347822
OXFORD OUT-OF-NETWORK ID
NJ
01
—
V8274
EMPIRE BCBS OUT-NETWORK
NY
Enumeration date
10/04/2006
Last updated
09/23/2022
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