Organization
MICHAEL R DUBIN MD AND WILLIAM R BASTA MD P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM ROBERT BASTA M.D. (PRESIDENT)
(516) 676-2878
Entity
Organization
Contact information
Practice address
3 SCHOOL ST, STE 303, GLEN COVE, NY 11542-2548
(516) 676-2878
(516) 674-2256
Mailing address
3 SCHOOL ST, STE 303, GLEN COVE, NY 11542-2548
(516) 676-2878
(516) 674-2256
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/29/2008
Last updated
12/20/2011
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