MEDICARE: DR. PASCALE BASTIEN M.D.

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	2080A0000X	Pediatric Adolescent Medicine Physician	MA64911	NJ
2	208000000X	Pediatrics Physician	25MA06491100	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598792566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PASCALE BASTIEN M.D.

Provider Business Mailing Address
First Line	:	8008 ROUTE 130 NORTH, SUITE 204
Second Line	:
City	:	DELRAN
State	:	NJ
Zip	:	08075-1869
Country	:	US
Telephone Number	:	856-824-0099
Fax Number	:	856-824-0088

Provider Business Practice Location Address
First Line	:	8008 ROUTE 130 N, SUITE 204
Second Line	:
City	:	DELRAN
State	:	NJ
Zip	:	08075-1869
Country	:	US
Telephone Number	:	856-824-0099
Fax Number	:	856-824-0088

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

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	01/02/2020

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Directions to “ DR. PASCALE BASTIEN M.D.” Practice Location

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