MEDICARE: DR. ROBERT JAMES BASILE PSY.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	103TC0700X	Clinical Psychologist	016805-1	NY

General Provider Information

NPI Number	:	1699881292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JAMES BASILE PSY.D.

Provider Business Mailing Address
First Line	:	160 W 86TH ST BSMT
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-4018
Country	:	US
Telephone Number	:	646-306-1404
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 W 86TH ST BSMT
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-4018
Country	:	US
Telephone Number	:	646-306-1404
Fax Number	:	844-906-2434

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

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	10/28/2024

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