Provider Demographics
NPI:1548239908
Name:BASILE, JOSEPH B (MD PC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:B
Last Name:BASILE
Suffix:
Gender:M
Credentials:MD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 FOREST HILL DR
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-7462
Mailing Address - Country:US
Mailing Address - Phone:845-331-3900
Mailing Address - Fax:845-331-3900
Practice Address - Street 1:218 FOREST HILL DR
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-7462
Practice Address - Country:US
Practice Address - Phone:845-331-3900
Practice Address - Fax:845-331-3900
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133805174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040426008190OtherFIDELIS
NY3224OtherGHI HMO
NY341241OtherEMPIRE BCBS
NYP381397OtherOXFORD
NY126162OtherUNITED HEALTHCARE
NYY016082OtherCHAMPUS
NY000405815001OtherBLUE SHIELD HEALTHNOW
NY027311OtherMVP HEALTHCARE
NY10013377OtherCDPHP
NY0050528OtherGHI
NY103224OtherWELLCARE
NY00536278Medicaid
NY5170121OtherAETNA US HEALTHCARE
NYY016082OtherCHAMPUS
NY126162OtherUNITED HEALTHCARE