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Individual

DR. ELLIOT L BASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2381 E 29TH ST, BROOKLYN, NY 11229-5027
(718) 743-1400
(718) 743-7003
Mailing address
2381 E 29TH ST, BROOKLYN, NY 11229-5027
(718) 743-1400
(718) 743-7003

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
002185
NY
213ES0131X
Foot Surgery Podiatrist
Primary
002185
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0017805
GHI
05
00403503
NY
Enumeration date
05/27/2005
Last updated
11/03/2010
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