Individual
MARYLEN BASILIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
403 CHEYENNE CT, TOMS RIVER, NJ 08755-4061
(732) 604-2094
Mailing address
403 CHEYENNE CT, TOMS RIVER, NJ 08755-4061
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
26NJ000854900
NJ
363LP2300X
Primary Care Nurse Practitioner
Primary
26NJ00854900
NJ
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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