Individual
DR. FARA DAWN BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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
Primary
NY005164
NY
213E00000X
Podiatrist
PO 002518
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01578803
—
NY
01
—
2030683
UNITED HEALTHCARE
—
01
—
6201069
GHI
—
01
—
P469339
OXFORD
—
Enumeration date
11/11/2005
Last updated
05/06/2011
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