Provider Demographics
NPI:1982976213
Name:BASCH, ROSS (MD)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:
Last Name:BASCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W END AVE
Mailing Address - Street 2:APT. 19C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4804
Mailing Address - Country:US
Mailing Address - Phone:212-580-2083
Mailing Address - Fax:212-263-0496
Practice Address - Street 1:205 W END AVE
Practice Address - Street 2:APT. 19C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4804
Practice Address - Country:US
Practice Address - Phone:212-580-2083
Practice Address - Fax:212-263-0496
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09481207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine