Organization
ELLIOT L BASS DPM, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIOT L BASS DPM (PRES.)
(718) 743-1400
Entity
Organization
Contact information
Practice address
2381 E 29TH ST, BROOKLYN, NY 11229-5027
(718) 743-1400
(718) 743-7003
Mailing address
38 LARCH HILL RD, LAWRENCE, NY 11559-1926
(718) 743-1400
(718) 743-7003
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017805
GHI
—
05
—
00403503
—
NY
05
—
01578803
—
NY
01
—
1528061082
NPI
—
01
—
1548241979
NPI
—
01
—
2030683
UNITED HEALTHCARE
—
01
—
6201069
GHI
—
01
—
P469339
OXFORD
—
Enumeration date
10/03/2007
Last updated
07/02/2008
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