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General NPI Number Information
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NPI Number | 1730876053
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Entity Type | Organization
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Legal Business Name | BASTIEN MEDICAL, PLLC
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 320 DEPOT LN
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City | CUTCHOGUE
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State | NY
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Zip | 11935-1274
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Country | US
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Telephone | 631-655-8920
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Fax |
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Provider Business Mailing Address
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Address Line | 347 5TH AVE RM 1402
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City | NEW YORK
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State | NY
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Zip | 10016-5034
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Country | US
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Telephone | 516-476-8353
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PEGGY BASTIEN
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Credential |
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Telephone | 516-476-8353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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