MEDICARE: RELINGTON BASTIEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0807X	Child & Adolescent Psychiatric/Mental Health Registered Nurse	658972	NY

General Provider Information

NPI Number	:	1477405645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RELINGTON BASTIEN

Provider Business Mailing Address
First Line	:	238 MALONEY LN
Second Line	:
City	:	TANNERSVILLE
State	:	PA
Zip	:	18372-7775
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	130 W KINGSBRIDGE RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-3904
Country	:	US
Telephone Number	:	718-584-9000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ RELINGTON BASTIEN ” Practice Location

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