Healthcare Provider Details

I. General information

NPI: 1679369409
Provider Name (Legal Business Name): BASIL CHRISTIAN INVESTMENTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 SYLVAN AVE
ENGLEWOOD CLIFFS NJ
07632-3132
US

IV. Provider business mailing address

1159 AVALON SQ
GLEN COVE NY
11542-2845
US

V. Phone/Fax

Practice location:
  • Phone: 617-637-5946
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: BASIL NWAOZ
Title or Position: OWNER
Credential:
Phone: 617-637-5946