Healthcare Provider Details

I. General information

NPI: 1255300588
Provider Name (Legal Business Name): ROBERT BAKLAJIAN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SEARS DR 3RD FLOOR
PARAMUS NJ
07652-3515
US

IV. Provider business mailing address

1 SEARS DRIVE SUITE 303
PARAMUS NJ
07652
US

V. Phone/Fax

Practice location:
  • Phone: 201-265-8282
  • Fax: 201-265-8680
Mailing address:
  • Phone: 201-265-8282
  • Fax: 201-265-8680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMA042952
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMA042952
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: