Individual
ANDREVITCH BASSIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
45 DOLSON AVE, MIDDLETOWN, NY 10940-6461
(845) 342-0746
(845) 342-1397
Mailing address
45 DOLSON AVE, MIDDLETOWN, NY 10940-6461
(845) 342-0746
(845) 342-1397
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
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