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Individual

MR. JONATHAN LEE BASS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
462 1ST AVE # A659, NEW YORK, NY 10016-9196
(646) 501-6784
Mailing address
462 1ST AVE # A659, NEW YORK, NY 10016-9196
(646) 501-6784

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
293507
NY
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
293507
NY

Other

Enumeration date
04/05/2011
Last updated
02/23/2021
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