Basic Information
Provider Information
NPI: 1801090667
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARON
FirstName: JEREMY
MiddleName: LAWRENCE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 45 BURNISTON CT
Address2:  
City: HILLSBOROUGH
State: NJ
PostalCode: 088442334
CountryCode: US
TelephoneNumber: 9739195619
FaxNumber:  
Practice Location
Address1: 285 DAVIDSON AVE
Address2: STE 204
City: SOMERSET
State: NJ
PostalCode: 088734153
CountryCode: US
TelephoneNumber: 7322711400
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/13/2007
LastUpdateDate: 03/06/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X25MA08509400NJY Allopathic & Osteopathic PhysiciansAnesthesiology 
207LP2900XMA08509400NJN Allopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine

No ID Information.


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