Individual
DR. DEAN ANTHONY BASULTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5141 BROADWAY, THE ALLEN HOSPITAL, RM 2-095, NEW YORK, NY 10034-1159
(212) 932-5218
(914) 932-5258
Mailing address
210 WESTCHESTER AVE, WHITE PLAINS, NY 10604-2901
(914) 682-6532
(914) 681-5260
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
205919
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
645K21
—
NY
Enumeration date
11/24/2006
Last updated
02/18/2020
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