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General NPI Number Information
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NPI Number | 1548516693
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Entity Type | Organization
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Legal Business Name | PASCALE BASTIEN MDPC
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Dates
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Enumeration Date | 07/26/2012
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 8008 ROUTE 130 STE 204
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City | DELRAN
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State | NJ
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Zip | 08075-1869
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Country | US
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Telephone | 856-824-0099
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Fax | 856-824-0088
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Provider Business Mailing Address
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Address Line | 8008 ROUTE 130 STE 204
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City | DELRAN
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State | NJ
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Zip | 08075-1869
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Country | US
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Telephone | 856-824-0099
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Fax | 856-824-0088
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Authorized Official
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Title or Position | OWNER
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Name | DR. PASCALE BASTIEN
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Credential | M.D
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Telephone | 856-824-0099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MA64911
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License Number State | NJ
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