Healthcare Provider Details

I. General information

NPI: 1326049693
Provider Name (Legal Business Name): ARNOLD BASKIES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 03/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SALEM RD SUITE A
WILLINGBORO NJ
08046-2852
US

IV. Provider business mailing address

401 ROUTE 73 N 40 LAKE CENTER DR SUITE 201A
MARLTON NJ
08053-3425
US

V. Phone/Fax

Practice location:
  • Phone: 609-877-1737
  • Fax: 609-877-1589
Mailing address:
  • Phone: 856-355-0340
  • Fax: 856-355-0346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA04093100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: