Healthcare Provider Details

I. General information

NPI: 1396654026
Provider Name (Legal Business Name): CHANDANIE BASDEO LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E 241ST ST
BRONX NY
10470-1303
US

IV. Provider business mailing address

12 MORNINGSIDE DR
MIDDLETOWN NY
10941-1021
US

V. Phone/Fax

Practice location:
  • Phone: 347-567-8426
  • Fax:
Mailing address:
  • Phone: 347-567-8426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number357739-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: