Individual
GABRIEL BASANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6084 MOUNT OLIVET CRES, MASPETH, NY 11378-3451
(347) 693-3695
Mailing address
6084 MOUNT OLIVET CRES, MASPETH, NY 11378-3451
(347) 693-3695
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
027079
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/24/2019
Last updated
03/16/2023
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