Base, Marvin J
Base, Marvin J is an sole proprietor health care provider with primary practice located at 65-11 Booth Street Suite 1C, Rego Park NY 11374-4184. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Base, Marvin J can be contacted via phone (718) 806-1434.Contact Information
Primary practice address
65-11 Booth Street Suite 1C
Rego Park NY 11374-4184
Phone: (718) 806-1434
Fax: (718) 806-1435
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 187770 | New York |
Profile Details
| NPI number | 1366401853 |
|---|---|
| LBN Legal business name | Base, Marvin J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 22nd, 2006 |
| Last updated | Jan 30th, 2019 - about 7 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 | 1366401853 | NPPES |
| New York | MEDICAID | 01888251 |
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