Individual
DR. DOMINICK BASILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7 ROSEMARY LN, CENTEREACH, NY 11720-4440
(631) 736-3015
(631) 736-9277
Mailing address
7 ROSEMARY LN, CENTEREACH, NY 11720-4440
(631) 736-3015
(631) 736-9277
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
160600
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0096653
GHI NUMBER
NY
05
—
01038251
—
NY
01
—
110020159
TRAVELERS MEDICARE
NY
01
—
1596
VYTRA
NY
01
—
4211813
AETNA
NY
01
—
6417676
CIGNA
NY
01
—
96D771
FEDERAL BLUE SHIELD
NY
01
—
AJ00073
MDNY NUMBER
NY
01
—
BLUE CROSS BLUE SHIE
BLUE CROSS BLUE SHIELD
NY
01
—
CP225
OXFORD PROVIDER NUMBER
NY
Enumeration date
10/11/2006
Last updated
02/14/2008
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