Provider Demographics
NPI:1437129301
Name:BASSON, MONETTE G (MD)
Entity Type:Individual
Prefix:DR
First Name:MONETTE
Middle Name:G
Last Name:BASSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:19 E 80TH ST
Mailing Address - Street 2:APT. 10D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0117
Mailing Address - Country:US
Mailing Address - Phone:212-249-5230
Mailing Address - Fax:
Practice Address - Street 1:6216 BROADWAY
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-2154
Practice Address - Country:US
Practice Address - Phone:718-335-5151
Practice Address - Fax:718-335-5219
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1032942084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology