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Individual

MS. JENNIFER BASINI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1 LAKE DR, RANDOLPH, NJ 07869-4165
(908) 647-4800
Mailing address
1 LAKE DR, RANDOLPH, NJ 07869-4165

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00051700
NJ

Other

Enumeration date
02/21/2013
Last updated
02/21/2013
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