Dr. Tina Basak, M.D.
Radiology, Diagnostic Radiology in Philadelphia, PA. Individual provider (NPI-1).
NPI number1487966735
StatusActive
Last updated in NPPESOct 7, 2023
Details
- NPI
- 1487966735
- Entity type
- Individual (NPI-1)
- Name
- Dr. Tina Basak
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 1, 2010
- Certification date
- Oct 7, 2023
- Last updated
- Oct 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | MD463749 | PA | Yes |
| 2085R0202X | Radiology, Diagnostic Radiology | A119265 | CA |
Practice location
3400 Spruce StPhiladelphia, PA 19104
Phone 215-662-3000
Mailing address
3400 Spruce StPhiladelphia, PA 19104-4238
Phone 215-662-3000
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