Provider Demographics
NPI:1861015935
Name:BASU RAY CARDIOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:BASU RAY CARDIOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:INDRANILL
Authorized Official - Middle Name:
Authorized Official - Last Name:BASU RAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-308-0580
Mailing Address - Street 1:1755 GROVEWAY DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38139-5554
Mailing Address - Country:US
Mailing Address - Phone:617-433-7775
Mailing Address - Fax:
Practice Address - Street 1:1755 GROVEWAY DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38139-5554
Practice Address - Country:US
Practice Address - Phone:617-433-7775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-25
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty