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1508072315
JACK BASILE
ALLENTOWN, PA
NPI
1508072315
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: PA OT011515)
Enumeration Date
2007-05-16
Last Update Date
2016-10-17
Business Address
-- JACK BASILE DO
1200 S CEDAR CREST BLVD
ALLENTOWN, PA 18103-6202
Phone number: 610-402-8111
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Mailing Address
-- JACK BASILE DO
PO BOX 783311
PHILADELPHIA, PA 19178-3311
Phone number: 484-884-4500
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