Provider Demographics
NPI:1700336344
Name:BASSAW, FRANCHESICA
Entity Type:Individual
Prefix:
First Name:FRANCHESICA
Middle Name:
Last Name:BASSAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 CUNNINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-1206
Mailing Address - Country:US
Mailing Address - Phone:516-712-8876
Mailing Address - Fax:
Practice Address - Street 1:103 CUNNINGHAM AVE
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-1206
Practice Address - Country:US
Practice Address - Phone:516-712-8876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst