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NPI Code Detail

MEDICARE: COURTNEY BASRAI

MEDICARE:   COURTNEY  BASRAI
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
1363AM0700XMedical Physician AssistantMA063442PA

General Provider Information

NPI Number : 1932856788
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY BASRAI
Provider Business Mailing Address
First Line : 1220 BUTTONWOOD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19123-3614
Country : US
Telephone Number : 215-349-8940
Fax Number :
Provider Business Practice Location Address
First Line : 3400 SPRUCE STREET
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4204
Country : US
Telephone Number : 215-615-0063
Fax Number : 215-349-8144
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2022
Last Update Date : 03/17/2026

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Directions to “ COURTNEY BASRAI ” Practice Location

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