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1841366713

NPI Code Detail

MEDICARE: DR. JAY ALAN BASSELL MD

MEDICARE: DR. JAY ALAN BASSELL 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
1	207V00000X	Obstetrics & Gynecology Physician	160412	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	976020	OTHER	NY	UNITED HEALTHCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	65N652	OTHER	NY	BLUE CROSS BLUE SHIELD
4	9507194	OTHER	NY	GHI
5	10000024896	OTHER	NY	AFFINITY
6	4353664	OTHER	NY	AETNA

General Provider Information

NPI Number	:	1841366713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY ALAN BASSELL MD

Provider Business Mailing Address
First Line	:	825 W END AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-5349
Country	:	US
Telephone Number	:	212-932-3027
Fax Number	:

Provider Business Practice Location Address
First Line	:	147-32 JAMAICA AVENUE
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-4042
Country	:	US
Telephone Number	:	718-786-5000
Fax Number	:

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

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	03/17/2018

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Directions to “ DR. JAY ALAN BASSELL MD” Practice Location

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