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General NPI Number Information
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NPI Number | 1174929673
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Entity Type | Individual
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Provider Name | KATHLEEN BASILE
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Gender | Female
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Dates
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Enumeration Date | 11/10/2014
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Last Update Date | 11/10/2014
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Provider Practice Location Address
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Address Line | 2043 MILITARY RD
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City | NIAGARA FALLS
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State | NY
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Zip | 14304-1724
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Country | US
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Telephone | 716-298-1777
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Fax | 716-298-1707
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Provider Business Mailing Address
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Address Line | 1707 LAKE RD
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City | YOUNGSTOWN
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State | NY
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Zip | 14174-9726
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Country | US
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Telephone | 716-745-7104
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 228744
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License Number State | NY
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