Organization Name: | BASSETT MEDICAL PC |
NPI Number: | 1790157303 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN J HENEGHAN (SOLE DIRECTOR AND PRESIDENT) |
Mailing Address: | 2037 Dream Catcher Plz Oneida |
State: | NY US |
Postal Code: | 134212729 |
Phone Number: | 6075473968 |
Fax Number: | |
NPI Enumeration Date: | 10/22/2015 |
NPI Last Update Date: | 10/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |