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General NPI Number Information
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NPI Number | 1982976213
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Entity Type | Individual
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Provider Name | ROSS BASCH M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 02/02/2012
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Provider Practice Location Address
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Address Line | 205 W END AVE APT. 19C
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City | NEW YORK
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State | NY
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Zip | 10023-4804
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Country | US
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Telephone | 212-580-2083
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Fax | 212-263-0496
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Provider Business Mailing Address
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Address Line | 205 W END AVE APT. 19C
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City | NEW YORK
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State | NY
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Zip | 10023-4804
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Country | US
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Telephone | 212-580-2083
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Fax | 212-263-0496
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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 | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | 09481
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License Number State | NY
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