Provider Demographics
NPI:1760277180
Name:BASHA, NIYAD
Entity type:Individual
Prefix:
First Name:NIYAD
Middle Name:
Last Name:BASHA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3469 KIMBERLY AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3235
Mailing Address - Country:US
Mailing Address - Phone:614-586-2932
Mailing Address - Fax:
Practice Address - Street 1:3469 KIMBERLY AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3235
Practice Address - Country:US
Practice Address - Phone:614-586-2932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care