Provider Demographics
NPI:1205874203
Name:MOHAMMAD BASIT, MDPC
Entity type:Organization
Organization Name:MOHAMMAD BASIT, MDPC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BASIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-220-4210
Mailing Address - Street 1:29 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3717
Mailing Address - Country:US
Mailing Address - Phone:718-220-4210
Mailing Address - Fax:718-220-4235
Practice Address - Street 1:2951 GRAND CONCOURSE
Practice Address - Street 2:SUITE1A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-1431
Practice Address - Country:US
Practice Address - Phone:718-220-4210
Practice Address - Fax:718-220-4230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199852207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWDW431Medicare ID - Type Unspecified