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1578104642
JOSE BASTIDAS
BRONX, NY
NPI
1578104642
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY 024304)
Enumeration Date
2019-09-30
Last Update Date
2019-11-27
Business Address
JOSE BASTIDAS PA
2015 GRAND CONCOURSE
BRONX, NY 10453-4303
Phone number: 718-299-7294
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Mailing Address
JOSE BASTIDAS PA
1434 WILLIAMSBRIDGE RD
BRONX, NY 10461-2507
Phone number: 718-618-0401
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