MEDICARE: ASHHAL M JASTANIAH MD

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	2084P0800X	Psychiatry Physician	214546	MA

General Provider Information

NPI Number	:	1679523773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHHAL M JASTANIAH MD

Provider Business Mailing Address
First Line	:	27 PARK ST
Second Line	:	CAPE COD HOSPITAL PSYCH CENTER
City	:	HYANNIS
State	:	MA
Zip	:	02601
Country	:	US
Telephone Number	:	508-862-5566
Fax Number	:	508-775-1598

Provider Business Practice Location Address
First Line	:	27 PARK ST
Second Line	:	CAPE COD HOSPITAL PSYCH CENTER
City	:	HYANNIS
State	:	MA
Zip	:	02601
Country	:	US
Telephone Number	:	508-862-5566
Fax Number	:	508-775-1598

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	07/08/2007

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