| Doctor Name: | SANJAY BASU |
| NPI Number: | 1285682450 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 227832 |
| Business Practice Address: | 200 Groton Rd Ayer, MA - 014321168 |
| Business Phone Number: | 9787849000 |
| Business Fax Number: | |
| Mailing Address: | 200 Groton Rd, AYER |
| State: | MA |
| Postal Code: | 014321168 |
| Phone Number: | 9787849000 |
| Fax Number: | |
| NPI Enumeration Date: | 05/04/2006 |
| NPI Last Update Date: | 07/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RA0401X |
| License Number: | 227832 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Addiction Medicine |
| Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |