Provider Demographics
NPI:1811015506
Name:PICKWARD J BASH JR MD PC.
Entity Type:Organization
Organization Name:PICKWARD J BASH JR MD PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:PICKWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-868-8418
Mailing Address - Street 1:2 CATHARINE ST 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12602
Mailing Address - Country:US
Mailing Address - Phone:866-868-8418
Mailing Address - Fax:845-790-2675
Practice Address - Street 1:1980 CROMPOND ROAD
Practice Address - Street 2:HUDSON VALLEY HOSPITAL CENTER
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567
Practice Address - Country:US
Practice Address - Phone:914-737-9000
Practice Address - Fax:845-790-2675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY13365LM831Medicare PIN