Provider Demographics
NPI:1528390192
Name:BASSI, SARA DANIELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:DANIELLE
Last Name:BASSI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:264 WASHINGTON AVENUE EXT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-6352
Mailing Address - Country:US
Mailing Address - Phone:518-213-8173
Mailing Address - Fax:615-963-9783
Practice Address - Street 1:264 WASHINGTON AVENUE EXT
Practice Address - Street 2:SUITE 200
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-6352
Practice Address - Country:US
Practice Address - Phone:518-213-8173
Practice Address - Fax:615-963-9783
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI053557-1183500000X
NJ28RI0328770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist