Individual
ANDREA BASILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7555 MAIN RD, MATTITUCK, NY 11952-1516
(631) 298-8642
Mailing address
7555 MAIN RD, MATTITUCK, NY 11952-1516
(631) 298-8642
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
P131772
NY
Other
Enumeration date
05/05/2025
Last updated
11/25/2025
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