Provider Demographics
NPI:1578634952
Name:BASSILA, MAHA K (MD)
Entity Type:Individual
Prefix:
First Name:MAHA
Middle Name:K
Last Name:BASSILA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1376 MIDLAND AVE
Mailing Address - Street 2:APT. 303
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-6891
Mailing Address - Country:US
Mailing Address - Phone:718-920-4646
Mailing Address - Fax:718-944-7207
Practice Address - Street 1:CHAM
Practice Address - Street 2:3415 BAINBRIDGE AVE, 5TH FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY159933207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology