person
Dr. Jack Lawrence Baldassare, MD
Diagnostic Radiology Physician in Tenafly, New Jersey
NPI 1225070121

Jack Lawrence Baldassare is a Diagnostic Radiology Physician based in Tenafly, NJ and is specialized in Diagnostic Radiology. Jack Lawrence Baldassare practices in Tenafly, NJ and has the professional credentials of MD. The NPI Number for Jack Lawrence Baldassare is 1225070121 and holds a License No. 25MA3606000 (New Jersey).

The current practice location address for Jack Lawrence Baldassare is 220 Oxford Dr, Tenafly, NJ and can be reached out via phone at 201-567-6156 and via fax at 201-871-8708.

Location: 220 Oxford Dr, Tenafly, NJ, 07670-3118
person
Provider Profile Details
NPI Number
1225070121
Provider Name
Jack Lawrence Baldassare
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
220 Oxford Dr, Tenafly, NJ, 07670-3118
Phone Number
201-567-6156
Fax Number
201-871-8708
Provider Enumeration Date
06/12/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00481521 05 NY
BA113644 01 NJ MEDICARE ID-TYPE
0864307 05 NJ
institution
Provider Business Practice Location Address Details
Address
220 Oxford Dr
City
State
Zip
07670-3118
Phone Number
201-567-6156
Fax Number
201-871-8708
person
Provider Business Mailing Address Details
Address
220 Oxford Dr
City
State
Zip
07670-3118
Phone Number
201-567-6156
Fax Number
201-871-8708
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
25MA3606000 (New Jersey)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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