| Organization Name: | LEONID BASOVICH, DO, PC |
| NPI Number: | 1366644106 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEONID BASOVICH (PRESIDENT) |
| Mailing Address: | 565 Route 25a Ste 101 Miller Place |
| State: | NY US |
| Postal Code: | 117642600 |
| Phone Number: | 6318494551 |
| Fax Number: | 6318494552 |
| NPI Enumeration Date: | 06/04/2007 |
| NPI Last Update Date: | 05/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 235997 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |