Individual
DR. PRIYANKA BASAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, 9NW63, PHILADELPHIA, PA 19104-4319
(215) 590-1220
(215) 590-2768
Mailing address
3401 CIVIC CENTER BLVD, DIVISION OF ANESTHESIOLOGY AND CRITICAL CARE, PHILADELPHIA, PA 19104
(215) 590-4557
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
MT203923
PA
208000000X
Pediatrics Physician
MT203923
PA
Other
Enumeration date
06/03/2013
Last updated
06/06/2017
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