Bass, Irina
Bass, Irina is an individual health care provider with primary practice located at 15-01 Broadway Suite36, Fair Lawn NJ 07410-6003. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bass, Irina can be contacted via phone (201) 773-6171.Contact Information
Primary practice address
15-01 Broadway Suite36
Fair Lawn NJ 07410-6003
Phone: (201) 773-6171
Fax: (201) 773-4845
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 25MA07639000 | New Jersey |
Profile Details
| NPI number | 1346212156 |
|---|---|
| LBN Legal business name | Bass, Irina |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1346212156 | NPPES |
| New Jersey | MEDICAID | 0081787 |
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