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1679719777
SUPARNA BASU
PEORIA, IL
NPI
1679719777
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: IL 036.147481)
Enumeration Date
2008-12-21
Last Update Date
2020-12-23
Business Address
SUPARNA BASU MD
228 NE JEFFERSON AVE
PEORIA, IL 61603-3802
Phone number: 309-671-8005
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Mailing Address
SUPARNA BASU MD
150 SAXON WOODS RD
SCARSDALE, NY 10583-7804
Phone number: 516-232-5732
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