Provider Demographics
NPI:1811127111
Name:JOSEPH B BASILE MD PC
Entity type:Organization
Organization Name:JOSEPH B BASILE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-331-3900
Mailing Address - Street 1:218 FOREST HILL DR
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-7462
Mailing Address - Country:US
Mailing Address - Phone:845-331-3900
Mailing Address - Fax:845-331-3900
Practice Address - Street 1:218 FOREST HILL DR
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-7462
Practice Address - Country:US
Practice Address - Phone:845-331-3900
Practice Address - Fax:845-331-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133805174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
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NYP381397OtherOXFORD
NY000405815001OtherBLUE SHIELD HEALTHNOW
NY00536278Medicaid
NYY016082OtherCHAMPUS
NY040426008190OtherFIDELIS
NY341241OtherEMPIRE BCBS
NY0050528OtherGHI
NY027311OtherMVP
NY10013377OtherCDPHP
NYP381397OtherOXFORD
341241Medicare PIN