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General NPI Number Information
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NPI Number | 1467945550
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Entity Type | Individual
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Provider Name | DEVLEEN BAKSI DO
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Gender | Male
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Dates
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Enumeration Date | 06/13/2018
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 94 OLD SHORT HILLS RD STE 1
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5668
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Country | US
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Telephone | 972-322-5000
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Fax |
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Provider Business Mailing Address
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Address Line | ROWANSOM 18 E. LAUREL RD
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City | STRATFORD
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State | NJ
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Zip | 08084
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Country | US
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Telephone | 856-346-7985
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MB11088400
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License Number State | NJ
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