| Basuk Medical Services Pllc | |
|
2011 Union Blvd Suite 1 Bay Shore NY 11706-8030 | |
| (631) 666-2900 | |
| (631) 666-2900 |
| Full Name | Basuk Medical Services Pllc |
|---|---|
| Speciality | Dermatology |
| Location | 2011 Union Blvd, Bay Shore, New York |
| Authorized Official Name and Position | Edward Goldberg (BOOKKEEPER) |
| Authorized Official Contact | 5168100561 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Basuk Medical Services Pllc 2011 Union Blvd Suite 1 Bay Shore NY 11706-8030 Ph: (631) 666-2900 | Basuk Medical Services Pllc 2011 Union Blvd Suite 1 Bay Shore NY 11706-8030 Ph: (631) 666-2900 |
| NPI Number | 1518206366 |
|---|---|
| Provider Enumeration Date | 02/13/2013 |
| Last Update Date | 07/15/2023 |
| Medicare PECOS PAC ID | 5698915650 |
|---|---|
| Medicare Enrollment ID | O20130716000255 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518206366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 207N00000X | Dermatology | (* (Not Available)) | Primary |
| Provider Name | Todd R Coven |
|---|---|
| Provider Type | Practitioner - Micrographic Dermatologic Surgery (mds) |
| Provider Identifiers | NPI Number: 1215943121 PECOS PAC ID: 3971554775 Enrollment ID: I20050209000667 |
| Provider Name | Howard Corwin |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1396792644 PECOS PAC ID: 8729005244 Enrollment ID: I20051024001147 |
| Provider Name | Khawaja Ali Hassan |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1639265416 PECOS PAC ID: 2163587346 Enrollment ID: I20090223000573 |
| Provider Name | Lawrence M Lieblich |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1619985462 PECOS PAC ID: 7113053422 Enrollment ID: I20100325000852 |
| Provider Name | Pamela J Basuk |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1255366977 PECOS PAC ID: 0446386999 Enrollment ID: I20100413000030 |
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