Organization
BASUK MEDICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD GOLDBERG (BOOKKEEPER)
(516) 810-0561
Entity
Organization
Contact information
Practice address
2011 UNION BLVD, SUITE 1, BAY SHORE, NY 11706-8030
(631) 666-2900
(631) 666-2900
Mailing address
2011 UNION BLVD, SUITE 1, BAY SHORE, NY 11706-8030
(631) 666-2900
(631) 666-2900
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
02/13/2013
Last updated
07/15/2023
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