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Contact Information

NICHOLAS G BARANETSKY, MD
268 DR MARTIN LUTHER KING JR BLVD STE B
NEWARK, NJ07102-2011
 Phone: 973-877-5185
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endocrinology, Diabetes & Metabolism

207RE0101X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for NICHOLAS G BARANETSKY · (Male)

NPI # 1093808164
Status Active
Credentials MD
Entity Individual
Enumeration date 10/02/2006
Last updated 03/30/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • NJ License # MA046790
  • NJ Medicaid 1080709
  • Other 28530 AETNA
  • Other E5102 OXFORD
Hospital affiliation(s)
  • SAINT MICHAEL'S MEDICAL CENTER INC - (Acute Care)
    111 CENTRAL AVENUE
    NEWARK, NJ 07102
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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