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General NPI Number Information
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NPI Number | 1811127111
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Entity Type | Organization
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Legal Business Name | JOSEPH B BASILE MD PC
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Dates
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Enumeration Date | 07/21/2009
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Last Update Date | 07/21/2009
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Provider Practice Location Address
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Address Line | 218 FOREST HILL DR
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City | KINGSTON
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State | NY
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Zip | 12401-7462
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Country | US
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Telephone | 845-331-3900
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Fax | 845-331-3900
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Provider Business Mailing Address
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Address Line | 218 FOREST HILL DR
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City | KINGSTON
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State | NY
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Zip | 12401-7462
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Country | US
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Telephone | 845-331-3900
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Fax | 845-331-3900
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JOAN KIMLIN
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Credential |
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Telephone | 845-331-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 133805
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License Number State | NY
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