| Doctor Name: | MRS. JOANN MARIE BASILE |
| NPI Number: | 1013357946 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | F400779 |
| Business Practice Address: | 1841 Brentwood Rd Brentwood, NY - 117174625 |
| Business Phone Number: | 6318537300 |
| Business Fax Number: | 6318537301 |
| Mailing Address: | 1841 Brentwood Rd, BRENTWOOD |
| State: | NY |
| Postal Code: | 117174625 |
| Phone Number: | 6318537300 |
| Fax Number: | 6318537301 |
| NPI Enumeration Date: | 06/25/2013 |
| NPI Last Update Date: | 06/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | F400779 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |