Individual
ILANA BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
440 W 114TH ST STE 610, NEW YORK, NY 10025-1796
(212) 523-8672
Mailing address
150 E 42ND ST FL 9, NEW YORK, NY 10017-5699
(646) 605-8186
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
294478
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2016
Last updated
05/03/2021
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