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General NPI Number Information
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NPI Number | 1346845229
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Entity Type | Individual
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Provider Name | JAMIE BASILE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/01/2020
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 107 MAIN ST
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2863
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Country | US
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Telephone | 732-634-6394
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Fax |
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Provider Business Mailing Address
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Address Line | 184 WHITE OAK RIDGE RD
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City | SHORT HILLS
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State | NJ
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Zip | 07078-2928
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03872100
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License Number State | NJ
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