Individual
BASDAI MOHAMMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
691065 DRIVE, PS128Q, MIDDLEVILLAGE QUEENS, NY 11379
(718) 326-6250
(718) 326-6251
Mailing address
69-10 65DRIVE, MIDDLEVILLAGE QUEENS, NY 11379
(718) 326-6250
(718) 326-6251
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
457729-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LISA0277
—
NY
Enumeration date
03/26/2012
Last updated
03/26/2012
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