Individual
MARCY A BASILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 OAK ST, BUFFALO, NY 14203-2233
(716) 856-4201
(716) 332-3570
Mailing address
752 NIAGARA ST, BUFFALO, NY 14213-2418
(716) 563-1055
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
005401
NY
Other
Enumeration date
06/25/2010
Last updated
06/25/2010
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