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NPI Code Detail

MEDICARE: SANJAY BASU MD

MEDICARE:   SANJAY  BASU  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician227832MA
2207RA0401XAddiction Medicine (Internal Medicine) Physician227832MA

General Provider Information

NPI Number : 1285682450
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANJAY BASU MD
Provider Business Mailing Address
First Line : 200 GROTON RD
Second Line :
City : AYER
State : MA
Zip : 01432-1168
Country : US
Telephone Number : 978-784-9000
Fax Number :
Provider Business Practice Location Address
First Line : 200 GROTON RD
Second Line :
City : AYER
State : MA
Zip : 01432-1168
Country : US
Telephone Number : 978-784-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 07/17/2015

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Directions to “ SANJAY BASU MD” Practice Location

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