Provider Demographics
NPI:1730200478
Name:PEDIATRICS AT THE BASIN
Entity type:Organization
Organization Name:PEDIATRICS AT THE BASIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOVEYS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-233-5565
Mailing Address - Street 1:32 SUNRISE HL
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-9778
Mailing Address - Country:US
Mailing Address - Phone:585-233-5565
Mailing Address - Fax:
Practice Address - Street 1:32 SUNRISE HL
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-9778
Practice Address - Country:US
Practice Address - Phone:585-233-5565
Practice Address - Fax:585-586-4984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190299208000000X
208000000X, 2083C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical InformaticsGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty