Individual
BASIL WILCHCOMBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 CENTRE AVE APT 1D, NEW ROCHELLE, NY 10805-2815
(516) 359-1402
Mailing address
130 CENTRE AVE APT 1D, NEW ROCHELLE, NY 10805-2815
(516) 359-1402
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
347503
NY
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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