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General NPI Number Information
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NPI Number | 1295395820
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Entity Type | Individual
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Provider Name | MR. SEAN MICHAEL VANBASTELAAR
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Gender | Male
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Dates
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Enumeration Date | 06/17/2019
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 801 OSTRUM ST
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015-1000
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Country | US
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Telephone | 610-954-5810
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Fax |
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Provider Business Mailing Address
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Address Line | 19 WOODBRIDGE DR
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City | DOYLESTOWN
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State | PA
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Zip | 18901-1965
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Country | US
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Telephone | 267-872-2014
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 26NJ01001000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN655230
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License Number State | PA
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