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Organization
PRIMARY CARE FAMILY DOCTOR P.C.
Active
Organization
PRIMARY CARE FAMILY DOCTOR P.C.
Active
Other names
Primary Care Family Doctors
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONID BASOVICH MD, DO (PRESIDENT)
(631) 849-4551
Entity
Organization
Contact information
Practice address
565 ROUTE 25A STE 101, MILLER PLACE, NY 11764-2600
(631) 849-4551
(631) 849-4552
Mailing address
PO BOX 383, MOUNT SINAI, NY 11766-0383
(631) 849-4551
(631) 849-4552
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/23/2012
Last updated
06/04/2020
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