Provider Demographics
NPI:1770708885
Name:BASSEN, DAISY G (MD)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:G
Last Name:BASSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PLAZA PSYCHOLOGY & PSYCHIATRY
Mailing Address - Street 2:816 MIDDLE RD
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818
Mailing Address - Country:US
Mailing Address - Phone:401-356-1940
Mailing Address - Fax:401-398-1136
Practice Address - Street 1:PLAZA PSYCHOLOGY & PSYCHIATRY
Practice Address - Street 2:816 MIDDLE RD
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818
Practice Address - Country:US
Practice Address - Phone:401-356-1940
Practice Address - Fax:401-398-1136
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD117852084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry