DR. KEVIN R BASRALIAN (NPI# 1851392252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851392252 |
| Entity Type | Individual |
| Full Name | DR. KEVIN R BASRALIAN |
| Credential | M.D. |
| Practice Address |
360 Essex St Suite 403 Hackensack NJ 07601-8550 |
| Practice Telephone | 5519968090 |
| Practice Fax Number | 5519968221 |
| Mailing Telephone | 5519968090 |
| Mailing Fax Number | 5519968221 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2014-12-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 25MA04654700 | NJ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | OXFORD ID # | BS138 | 01 |
| NJ | BCBS NY CARLSTADT | 5S1641 | 01 |
| NJ | AETNA PPO ID # | 4239813 | 01 |
| NJ | AETNA HMO ID # | 0457763 | 01 |
| NJ | AMERIHEALTH HMO ID # | 0103347000 | 01 |
| NJ | BC/BS NY (HACKENSACK) # | 80D693 | 01 |
| NJ | RAILROAD MDCR # | 340001947 | 01 |
| NJ | 1211200 | 05 |
| Street Address |
360 ESSEX ST SUITE 403 |
| City | HACKENSACK |
| State | NJ |
| Zip Code | 07601-8550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114348976 | Hackensack University Medical Center | Urology | 360 Essex St, Suite 403, Hackensack, NJ 07601-8550 | 2013-12-21 |
| 1972802783 | Melissa Serravallo | Dermatology | 360 Essex St, Suite 201, Hackensack, NJ 07601-8550 | 2011-03-18 |
| 1235451196 | Ting F Lui | Pharmacist | 360 Essex St, Hackensack, NJ 07601-8550 | 2010-02-19 |
| 1164754552 | Mark Ayirebi Ntiamoah | Pharmacist | 360 Essex St, Hackensack, NJ 07601-8550 | 2010-02-10 |
| 1700114931 | Mohammad A Younus | Allergy & Immunology | 360 Essex St, Suite 302, Hackensack, NJ 07601-8550 | 2009-11-29 |
| 1164608840 | So Yeon Lee | Pharmacist | 360 Essex St, Hackensack, NJ 07601-8550 | 2008-01-13 |
| 1598965675 | Karen M Minnett | Physical Therapist | 360 Essex St, Suite 202, Hackensack, NJ 07601-8550 | 2007-07-18 |
| 1619182276 | Yair David Kissin | Orthopaedic Surgery | 360 Essex St, Suite 303, Hackensack, NJ 07601-8550 | 2007-05-14 |
| 1689896722 | Michelle J Kim | Urology | 360 Essex St, Dept of Urology, Hackensack, NJ 07601-8550 | 2007-05-02 |
| 1174663231 | Jumana Shammout | Specialist | 360 Essex St, Suite # 402, Hackensack, NJ 07601-8550 | 2007-02-07 |
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|---|---|---|---|---|
| 1750989414 | Alpha Healthcare Staffing Firm, LLC | Registered Nurse | 194 Passaic Street, Hackensack, NJ 07601 | 2020-10-15 |
| 1396350120 | Lower Limb Institute | Podiatrist | 211 Esses Street, Suite 405, Hackesack, NJ 07601 | 2020-09-09 |
| 1649825233 | Rachel Korenblit | Social Worker | 235 Main St Ste 203, Hackensack, NJ 07601 | 2019-08-09 |
| 1740846567 | Samantha Pirnat | Counselor | 426 Hudson Street, 2nd Floor, Hackensack, NJ 07601 | 2019-05-16 |
| 1881258499 | Tara Lynn Smith | Social Worker | 160 South River Street, Hackensack, NJ 07601 | 2019-04-29 |
| 1922569318 | Solomon Isakov | Dentist | 835 Prospect Ave, Suite 304, Hackensack, NJ 07601 | 2019-03-27 |
| 1114403409 | Mildred Lopez Vasquez | Home Health Aide | 12 Rowland Avenue, Hackensack, NJ 07601 | 2018-07-19 |
| 1538656582 | Zara Pharmacy LLC | Pharmacy | 57 Linden St, Hackensack, NJ 07601 | 2018-04-16 |
| 1447759048 | Maryann Hom | Social Worker | 307 Prospect Avenue, 14e, Hackensack, NJ 07601 | 2018-02-08 |
| 1699274258 | Kirsten Byrnes | Psychologist | Audrey Hepburn Children's House, Hackensack Umc, 12 Second St, Hackensack, NJ 07601 | 2018-02-08 |
| Find all providers in zip 07601 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073968095 | Stephanie Garcia | Specialist | 364 Parker Ave, Hackensack, NJ 07601-1832 | 2016-04-27 |
| 1699143594 | John Oliver Manansala Hernandez | Specialist | 54 Frederick St, Hackensack, NJ 07601-5235 | 2015-09-09 |
| 1205257748 | Morris Anesthesiology Consultants of Nj LLC | Specialist | 180 Main St Fl 2, Hackensack, NJ 07601-7125 | 2013-12-31 |
| 1598011645 | Felix Paulino | Specialist | 475 Colonial Ter Apt 5, Hackensack, NJ 07601-1426 | 2012-07-26 |
| 1811250400 | Denise Soto | Specialist | 150 Overlook Ave Apt 3e, Hackensack, NJ 07601-2222 | 2012-06-19 |
| 1558624387 | Yvette M Ramos | Specialist | 140 Prospect Ave Apt 9m, Hackensack, NJ 07601-2248 | 2012-06-18 |
| 1275857468 | Yitzhack Asulin, Md, PC | Specialist | 20 Prospect Ave Ste 719, Hackensack, NJ 07601-1974 | 2010-03-17 |
| 1255587366 | Michael P Silverstein | Specialist | 211 Essex St Ste 202, Hackensack, NJ 07601-3245 | 2008-08-09 |
| 1609049501 | Manoucher Katebian, M.d. Pa | Specialist | 274 Summit Ave, Hackensack, NJ 07601-1432 | 2008-04-11 |
| 1881899532 | Excelsior Women's Care P.a | Specialist | 170 Prospect Ave Ste 4, Hackensack, NJ 07601-1834 | 2007-06-20 |
| Find all providers in HACKENSACK | ||||
| City | HACKENSACK |
| Zip Code | 07601 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.