Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 278908 | NY |
NPI | 1285977090 |
---|---|
Provider Name | Abby Miriam Basalely |
First Address | New Hyde Park, NY 11042-1121 |
Second Address | New Hyde Park, NY 11042-1121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2013 |
Last Update Date | 24/03/2020 |