Individual
ANIKA BASCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 E 21ST ST, APT 4L, BROOKLYN, NY 11226-6864
(347) 663-6933
Mailing address
520 E 21ST ST, APT 4L, BROOKLYN, NY 11226-6864
(347) 663-6933
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
705595
NY
164W00000X
Licensed Practical Nurse
274286
NY
Other
Enumeration date
06/10/2009
Last updated
03/21/2018
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