Organization
LEONID BASOVICH, DO, PC
Active
Other names
Leonid Basovich, DO, PC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONID BASOVICH DO (PRESIDENT)
(516) 884-2349
Entity
Organization
Contact information
Practice address
565 ROUTE 25A STE 101, MILLER PLACE, NY 11764-2600
(631) 849-4551
(631) 849-4552
Mailing address
4232 SPRING LN, FAIR OAKS, CA 95628-7089
(516) 884-2349
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
235997
NY
207Q00000X
Family Medicine Physician
Primary
235997
NY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
235997
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366644106
NPI
NY
Enumeration date
06/04/2007
Last updated
06/04/2020
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