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Individual

DR. GEOFFREY H BASSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
111 E 210TH ST, BRONX, NY 10467
(718) 920-5561
Mailing address
19 E 80TH ST APT 10D, NEW YORK, NY 10075-0170
(212) 249-5230

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
103293
NY
207WX0109X
Neuro-ophthalmology Physician
Primary
103293
NY
2084N0400X
Neurology Physician
103293
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00179319
NY
Enumeration date
01/22/2006
Last updated
05/23/2018
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