Provider Demographics
NPI:1235198771
Name:BASSAM ALDAIA MD LLP
Entity Type:Organization
Organization Name:BASSAM ALDAIA MD LLP
Other - Org Name:BASSAM N. ALDAIA, MD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BASSAM
Authorized Official - Middle Name:NICOLA
Authorized Official - Last Name:ALDAIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-836-1598
Mailing Address - Street 1:660 92ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3621
Mailing Address - Country:US
Mailing Address - Phone:718-836-1598
Mailing Address - Fax:718-836-7672
Practice Address - Street 1:660 92ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3621
Practice Address - Country:US
Practice Address - Phone:718-836-1598
Practice Address - Fax:718-836-7672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128836207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
421-3921OtherAETNA
OP222OtherOXFORD
00435706OtherMAGNACARE
NY0201503OtherGROUP HEALTH INCORP. (GHI
NY128836OtherNYS MEDICAL LICENSE
354121OtherBLUE CROSS
4C1093OtherACS HEALTHNET
V00454329OtherAMERICHOICE
NY00339717Medicaid
NY00339717Medicaid
NY128836OtherNYS MEDICAL LICENSE
=========Other1199
=========OtherUNITED HEALTHCARE
NY00339717Medicaid