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NPI Code Detail

MEDICARE: KATINA BASEY

MEDICARE: KATINA BASEY
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
1172A00000XDriver

General Provider Information

NPI Number : 1891569067
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATINA BASEY
Provider Business Mailing Address
First Line : 30799 PINETREE RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44124-5903
Country : US
Telephone Number : 513-507-9407
Fax Number :
Provider Business Practice Location Address
First Line : 25701 N LAKELAND BLVD STE 403
Second Line :
City : EUCLID
State : OH
Zip : 44132-2453
Country : US
Telephone Number : 513-507-9407
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2023
Last Update Date : 03/12/2026

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Directions to “ KATINA BASEY ” Practice Location

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