Patricia Jeanne Basmajian, LCSW-R

Individual provider Active NPI Clinical Social Worker · Vestal, NY

NPI 1780151456 · NPPES record last updated Oct 31, 2018

Key facts

NPI
1780151456
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
R0441036-1 (NY)
Practice address
4102 Vestal Rd
Vestal, NY 13850-3531
Phone
(607) 772-1598
Fax
(607) 584-7679
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
R0441036-1NYMDClinical Social Worker
041036NYMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R0441036-1 NY Yes

Addresses

Primary practice location

4102 Vestal Rd
Vestal, NY 13850-3531

Mailing address

4102 Vestal Rd
Vestal, NY 13850-3531
Phone (607) 772-1598

Other providers in Vestal, NY

All providers in Vestal, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.