Basking Ridge Pediatric Health Center

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA02405700 Issued in NJ

Legal business name

BASKING RIDGE PEDIATRIC HEALTH CENTER

Practice address

150 N Finley Ave
Basking Ridge, NJ 07920-1686

Phone

(908) 766-4660

Fax

(908) 204-9871

NPI assigned

Apr 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Henry J Kim, M.D.

Title

Owner

Phone

(908) 766-4600

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1114191608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N FINLEY AVE",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079201686",
            "telephone_number": "908-766-4660",
            "fax_number": "908-204-9871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N FINLEY AVE",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079201686",
            "telephone_number": "908-766-4660",
            "fax_number": "908-204-9871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASKING RIDGE PEDIATRIC HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-766-4600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA02405700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "TP050",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0467103",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEA;THNET",
            "identifier": "OK4548",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Banasiak, DMD
• Rouba Barkoudeh
• Francesca Barrett, MD MBA
• Basking Ridge Fire Company No. 1
• Basking Ridge Pediatric Dentistry, LLC
• Basking Ridge Physical Therapy, LLC
• Basking Ridge Project Partnership, LLC
• Tammy K Bassin, RPH
• Sophia Baurkot
• Bay Area Radiology, PC

• Pediatrics Physician in Basking Ridge, NJ
• Providers in Basking Ridge, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.