Provider Demographics
NPI:1538574421
Name:BASALAY, NICHOLAS PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:PAUL
Last Name:BASALAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:985582 NEBRASKA MEDICAL CTR DEPT OF
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-5582
Mailing Address - Country:US
Mailing Address - Phone:402-552-6222
Mailing Address - Fax:
Practice Address - Street 1:985582 NEBRASKA MEDICAL CTR DEPT OF
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-5582
Practice Address - Country:US
Practice Address - Phone:402-552-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE72892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry