MEDICARE: DR. GEOFFREY H BASSON M.D.

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
1	207W00000X	Ophthalmology Physician	103293	NY
2	2084N0400X	Neurology Physician	103293	NY
3	207WX0109X	Neuro-ophthalmology Physician	103293	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427038603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEOFFREY H BASSON M.D.

Provider Business Mailing Address
First Line	:	19 E 80TH ST APT 10D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-0170
Country	:	US
Telephone Number	:	212-249-5230
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 E 210TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467
Country	:	US
Telephone Number	:	718-920-5561
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2006
Last Update Date	:	05/23/2018

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