Individual provider · NPI-1

Marylen Basilio, NP

Nurse Practitioner, Primary Care · Toms River, NJ

NPI number1982173233
StatusActive
Last updated in NPPESNov 15, 2018

Details

NPI
1982173233
Entity type
Individual (NPI-1)
Name
Marylen Basilio
Credential
NP
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 15, 2018
Last updated
Nov 15, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP2300X Nurse Practitioner, Primary Care26NJ00854900NJYes
363LG0600X Nurse Practitioner, Gerontology26NJ000854900NJ

Practice location

403 Cheyenne Ct
Toms River, NJ 08755-4061

Phone 732-604-2094

Mailing address

403 Cheyenne Ct
Toms River, NJ 08755-4061

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