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General NPI Number Information
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NPI Number | 1568766129
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Entity Type | Organization
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Legal Business Name | BASMALA MEDICAL P.C.
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Dates
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Enumeration Date | 12/22/2010
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Last Update Date | 12/22/2010
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Provider Practice Location Address
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Address Line | 162 E 78TH ST FL 3
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City | NEW YORK
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State | NY
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Zip | 10075-0406
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Country | US
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Telephone | 212-879-1717
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Fax | 212-879-4025
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Provider Business Mailing Address
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Address Line | 162 E 78TH ST FL 3
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City | NEW YORK
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State | NY
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Zip | 10075-0406
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Country | US
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Telephone | 212-879-1717
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Fax | 212-879-4025
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. TAMER ELBAZ
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Credential | MD
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Telephone | 212-879-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 231996
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 231996
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License Number State | NY
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