=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689053126
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BASICARE MEDICAL PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/28/2015
-----------------------------------------------------
Last Update Date | 10/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3808 UNION ST STE 7C
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11354-5672
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-886-2828
-----------------------------------------------------
Fax | 718-475-9607
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3808 UNION ST STE 7C
-----------------------------------------------------
City | FLUSHING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11354-5672
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-886-2828
-----------------------------------------------------
Fax | 718-475-9607
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MD/PRESIDENT
-----------------------------------------------------
Name | YONG LUO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 718-886-2828
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207KA0200X
-----------------------------------------------------
Taxonomy Name | Allergy Physician
-----------------------------------------------------
License Number | 261914-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RA0201X
-----------------------------------------------------
Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
-----------------------------------------------------
License Number | 261914-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------