Individual
CARLOS M BASTIDAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN-BSN
Contact information
Practice address
6360 98TH ST, APARTMENT B-17, REGO PARK, NY 11374-2238
(917) 705-9578
Mailing address
6360 98TH ST, APARTMENT B-17, REGO PARK, NY 11374-2238
(917) 705-9578
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
561861
NY
Other
Enumeration date
11/04/2014
Last updated
11/04/2014
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