Provider Demographics
NPI:1790157303
Name:BASSETT MEDICAL PC
Entity Type:Organization
Organization Name:BASSETT MEDICAL PC
Other - Org Name:BASSETT ONEIDA HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE DIRECTOR AND PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HENEGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-547-3968
Mailing Address - Street 1:2037 DREAM CATCHER PLZ
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2729
Mailing Address - Country:US
Mailing Address - Phone:607-547-3968
Mailing Address - Fax:
Practice Address - Street 1:2037 DREAM CATCHER PLZ
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2729
Practice Address - Country:US
Practice Address - Phone:607-547-3968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty