Individual
MS. NICOLE ANNE BASEIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1402
(718) 413-1077
Mailing address
1024 ELSTON DR, MOUNTAINSIDE, NJ 07092-2112
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
017054
NY
Other
Enumeration date
09/30/2013
Last updated
01/27/2017
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