Basiliere, Russell James

Basiliere, Russell James is an sole proprietor health care provider with primary practice located at 109 S Warren St Ste 301 , Syracuse NY 13202-1798. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as his primary health care specialty. Basiliere, Russell James can be contacted via phone (315) 937-5953.

Contact Information

Primary practice address
109 S Warren St Ste 301 Syracuse NY 13202-1798
Phone: (315) 937-5953
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 030876-01 New York

Profile Details

NPI number 1427778380
LBN Legal business name Basiliere, Russell James
Credentials LMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 31st, 2022
Last updated Aug 31st, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427778380 NPPES
New York Other 030876-01 MASSAGE THERAPY

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