Individual
MRS. CARMEN MILLICENT BASSARAGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
421 DEER PARK AVE, BABYLON, NY 11702-2313
(631) 941-1000
Mailing address
421 DEER PARK AVE, BABYLON, NY 11702-2313
(631) 941-1000
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
000575-1
NY
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
F305792-
NY
Other
Enumeration date
05/22/2012
Last updated
02/28/2017
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