Individual
VINCENT P BASILICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.,P.C.
Contact information
Practice address
3400 NESCONSET HWY, SUITE 107, EAST SETAUKET, NY 11733-3327
(631) 751-2020
(631) 751-0048
Mailing address
3400 NESCONSET HWY, SUITE 107, EAST SETAUKET, NY 11733-3327
(631) 751-2020
(631) 751-0048
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
127126-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00417469
—
NY
01
—
1679588164
GROUP NPI NUMBER
NY
Enumeration date
04/10/2007
Last updated
10/07/2020
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