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Individual

MS. CAROL MARY BASENER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
60 ONYX DR, PENFIELD, NY 14526-2859
(585) 377-0892
Mailing address
60 ONYX DR, PENFIELD, NY 14526-2859
(585) 377-0892

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
327780
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
327780
REGISTERED NURSE
NY
Enumeration date
08/13/2012
Last updated
08/13/2012
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