Organization
PRITHWIJIT BASU MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRITHWIJIT BASU MD (PRESIDENT)
(718) 897-0584
Entity
Organization
Contact information
Practice address
5 STATION SQ, FOREST HILLS, NY 11375-5232
(718) 897-0584
(718) 896-5571
Mailing address
5 STATION SQ, FOREST HILLS, NY 11375-5232
(718) 897-0584
(718) 896-5571
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
190318
NY
207RG0100X
Gastroenterology Physician
Primary
190318
NY
207RI0008X
Hepatology Physician
190318
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01466908
—
NY
Enumeration date
12/16/2011
Last updated
12/16/2011
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