Individual provider · NPI-1
Carmen Millicent Bassaragh, ANP-C
Clinical Nurse Specialist, Adult Health · Babylon, NY
NPI number1679833784
StatusActive
Last updated in NPPESFeb 28, 2017
Details
- NPI
- 1679833784
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Carmen Millicent Bassaragh
- Credential
- ANP-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 22, 2012
- Last updated
- Feb 28, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 364SA2200X | Clinical Nurse Specialist, Adult Health | F305792- | NY | Yes |
| 133V00000X | Dietitian, Registered | 000575-1 | NY |
Practice location
421 Deer Park AveBabylon, NY 11702-2313
Phone 631-941-1000
Mailing address
421 Deer Park AveBabylon, NY 11702-2313
Phone 631-941-1000
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