Individual
DR. KATHLEEN ANN BASILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
888 WORCESTER ST, SUITE 130, WELLESLEY, MA 02482-3744
(617) 964-6681
(339) 686-2561
Mailing address
888 WORCESTER ST, SUITE 130, WELLESLEY, MA 02482-3744
(617) 964-6681
(339) 686-2561
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3573
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0356018
—
MA
01
—
410045312
MEDICARE RAILROAD
MA
01
—
W15836
BLUE CROSS BLUE SHIELD
MA
Enumeration date
07/09/2006
Last updated
08/27/2012
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