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Individual

BRUCE A BASSITY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1001 KNIK-GOOSEBAY ROAD, WASILLA, AK 99654
(907) 631-7889
(907) 631-7612
Mailing address
1001 KNIK-GOOSEBAY ROAD, WASILLA, AK 99654
(907) 631-7889
(907) 631-7612

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
779
AK
363AM0700X
Medical Physician Assistant
008720
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DD2004
NY
05
MDA0120
AK
Enumeration date
01/03/2007
Last updated
08/20/2013
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