Provider Demographics
NPI:1689365389
Name:BASEM HAKIM PODIATRY PC
Entity Type:Organization
Organization Name:BASEM HAKIM PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BASEM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:267-642-4091
Mailing Address - Street 1:11 ELMWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-6123
Mailing Address - Country:US
Mailing Address - Phone:267-642-4091
Mailing Address - Fax:
Practice Address - Street 1:1111 BROADHOLLOW RD
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-4820
Practice Address - Country:US
Practice Address - Phone:267-642-4091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty