Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 057729 | NY |
NPI | 1134511603 |
---|---|
Provider Name | Simronjeet Basati |
First Address | New York, NY 10016-8323 |
Second Address | New York, NY 10038-3101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2015 |
Last Update Date | 20/02/2015 |