Individual
DR. SERGEY YEVGENYEVICH BASIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
707 ELIZABETH AVE, ELIZABETH, NJ 07201-2806
(908) 354-1500
Mailing address
707 ELIZABETH AVE, ELIZABETH, NJ 07201-2806
(908) 354-1500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
052095
NY
1223G0001X
General Practice Dentistry
Primary
22DI02292100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150258
—
NJ
05
—
02664973
—
NY
Enumeration date
01/31/2007
Last updated
03/12/2008
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