Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 159933 | NY |
NPI | 1578634952 |
---|---|
Provider Name | Maha K Bassila |
First Address | Bronxville, NY 10708-6891 |
Second Address | Bronx, NY 10467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2006 |
Last Update Date | 08/07/2007 |