Individual
DR. MICHAEL PAUL BASISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1355 BROAD ST, CLIFTON, NJ 07013-4221
(973) 778-5566
Mailing address
1355 BROAD ST, CLIFTON, NJ 07013-4221
(973) 778-5566
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA035109
NJ
Other
Enumeration date
06/14/2006
Last updated
08/08/2007
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