Individual
MAE BASOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
726 BROADWAY, 4TH FLOOR, SUITE 471, NEW YORK, NY 10003-9502
(212) 998-4378
Mailing address
60 REMSEN ST, PROF SUITE, BROOKLYN, NY 11201
(347) 560-3139
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
020551
NY
Other
Enumeration date
06/03/2015
Last updated
05/22/2020
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