National Provider Identifier
Grace Anna Basden, PA-C
Grace Anna Basden, PA-C is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Lockport, NY and a listed phone number of (716) 778-8627.
Profile Overview
- NPI
- 1083497788
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- August 16, 2023
- Last Updated
- August 16, 2023
Practice Location
- 5949 Campbell Blvd
- Lockport, NY 14094-9204
Phone: (716) 778-8627
Specialties
- Family Medicine Physician (207Q00000X)
Full Record
- NPI
- 1083497788
- Entity Type
- Individual
- Last Name
- Basden
- First Name
- Grace
- Middle Name
- Anna
- Credential
- PA-C
- Mailing Street Address
- 5949 Campbell Blvd
- Mailing City
- Lockport
- Mailing State
- NY
- Mailing ZIP Code
- 14094-9204
- Mailing Country
- US
- Practice Street Address
- 5949 Campbell Blvd
- Practice City
- Lockport
- Practice State
- NY
- Practice ZIP Code
- 14094-9204
- Practice Country
- US
- Practice Phone
- (716) 778-8627
- Enumeration Date
- August 16, 2023
- Last Updated
- August 16, 2023
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- August 16, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X)