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General NPI Number Information
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NPI Number | 1194902569
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Entity Type | Individual
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Provider Name | YVES LUC BASSE M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 829 EMPIRE AVE
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-4856
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Country | US
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Telephone | 718-327-2101
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Fax |
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Provider Business Mailing Address
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Address Line | 2335 WESTLAKE CT
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City | OCEANSIDE
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State | NY
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Zip | 11572-1415
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Country | US
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Telephone | 516-678-4428
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 177998
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License Number State | NY
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