Individual
ANDREVITCH BASSIG
Active
Individual
ANDREVITCH BASSIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
022509
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10766681
CAQH
NY
01
—
LICENSE
022509
NY
01
—
QL5651
BLUE CROSS BLUE SHIELD
NY
Enumeration date
05/10/2007
Last updated
07/08/2007
Update your record
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