Provider Demographics
NPI:1518390152
Name:BASIN, EVE (MS ED)
Entity Type:Individual
Prefix:MS
First Name:EVE
Middle Name:
Last Name:BASIN
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 AVENUE X
Mailing Address - Street 2:APT. 4C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4269
Mailing Address - Country:US
Mailing Address - Phone:718-801-0323
Mailing Address - Fax:
Practice Address - Street 1:1245 AVENUE X
Practice Address - Street 2:APT. 4C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4269
Practice Address - Country:US
Practice Address - Phone:718-801-0323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist