# LEWIS BASS DO PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689840787
- **Authorized official:** DR. LEWIS BASS MD (PRESIDENT)
- **Authorized official phone:** (516) 625-1944

## Contact information

- **Practice address:** 58 50 CATALPA AVE, RIDGEWOOD, NY 11385-5032
- **Practice address phone:** (718) 821-1969
- **Practice address fax:** (718) 821-1125
- **Mailing address:** 31 PEACOCK DR, ROSLYN, NY 11576-2522
- **Mailing address phone:** (516) 625-1944
- **Mailing address fax:** (516) 626-6680

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 124814 | NY | — |
| 207Q00000X | Family Medicine Physician | 124814 | NY | Yes |

## Other

- **Enumeration date:** 05/08/2008
- **Last updated:** 05/08/2008