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General NPI Number Information
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NPI Number | 1831548882
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Entity Type | Individual
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Provider Name | BASANT NASSAR M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 111 MICHIGAN AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20010-2916
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Country | US
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Telephone | 24-764-4782
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Fax |
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Provider Business Mailing Address
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Address Line | 400 MADRID AVE
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City | BLOOMSBURG
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State | PA
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Zip | 17815-3147
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Country | US
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Telephone | 570-854-1363
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD047403
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD480501
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD480501
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License Number State | PA
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