| Basith Medical Care Pllc | |
|
9747 77th St Ozone Park NY 11416-1943 | |
| (718) 307-5796 | |
| Not Available |
| Full Name | Basith Medical Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9747 77th St, Ozone Park, New York |
| Authorized Official Name and Position | Mohammed A Basith (OWNER) |
| Authorized Official Contact | 7188777407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Basith Medical Care Pllc 17033 83rd Ave Jamaica NY 11432-2101 Ph: (718) 877-7407 | Basith Medical Care Pllc 9747 77th St Ozone Park NY 11416-1943 Ph: (718) 307-5796 |
| NPI Number | 1821581299 |
|---|---|
| Provider Enumeration Date | 06/11/2018 |
| Last Update Date | 06/11/2018 |
| Medicare PECOS PAC ID | 1456600808 |
|---|---|
| Medicare Enrollment ID | O20180820000934 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821581299 | NPI | - | NPPES |
| 03269261 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 258439 (New York) | Primary |
| Provider Name | Mohammed A Basith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144548843 PECOS PAC ID: 3375711088 Enrollment ID: I20140819001692 |
| Provider Name | Shamsi Y Rahman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154705176 PECOS PAC ID: 5890128151 Enrollment ID: I20191129000007 |
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