Baselice, Marino
Baselice, Marino is an individual health care provider with primary practice located at 250 Delaware Ave , Delmar NY 12054-1420. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Baselice, Marino can be contacted via phone (518) 439-8077.Contact Information
Primary practice address
250 Delaware Ave
Delmar NY 12054-1420
Phone: (518) 439-8077
Fax: (518) 439-8070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 134658 | New York |
Profile Details
| NPI number | 1174607014 |
|---|---|
| LBN Legal business name | Baselice, Marino |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2006 |
| Last updated | Jul 10th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174607014 | NPPES |
| New York | MEDICAID | 00555091 |
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