Provider Demographics
NPI:1043301047
Name:BASKIN, KEVIN MARIN (MD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:MARIN
Last Name:BASKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2438 BRODHEAD RD
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-4271
Mailing Address - Country:US
Mailing Address - Phone:412-551-3452
Mailing Address - Fax:724-857-0855
Practice Address - Street 1:2438 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:ALIQUIPPA
Practice Address - State:PA
Practice Address - Zip Code:15001-4271
Practice Address - Country:US
Practice Address - Phone:412-551-3452
Practice Address - Fax:724-857-0855
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4174182085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA088521Medicare PIN
PA103866YCYYMedicare PIN
PAP00974892Medicare PIN
PADO6431Medicare PIN
PA137760Medicare PIN
PA103866ZAAQMedicare PIN
PA194873Medicare PIN