Provider Demographics
NPI:1235248303
Name:KOCUR, BASIL A (MD)
Entity Type:Individual
Prefix:DR
First Name:BASIL
Middle Name:A
Last Name:KOCUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5323
Mailing Address - Country:US
Mailing Address - Phone:914-722-2600
Mailing Address - Fax:914-719-4700
Practice Address - Street 1:688 WHITE PLAINS RD
Practice Address - Street 2:SUITE 221
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5059
Practice Address - Country:US
Practice Address - Phone:914-722-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179608207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF20484Medicare UPIN