Organization
BASTIDAS PLASTIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIME A BASTIDAS M.D. (PRESIDENT)
(212) 734-6621
Entity
Organization
Contact information
Practice address
599 BROADWAY, UNIT 1A, PATERSON, NJ 07514-1969
(610) 442-0992
Mailing address
5388 ROLLING HILLS RD, SAYLORSBURG, PA 18353-8054
(610) 442-0992
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
25MA07689900
NJ
Other
Enumeration date
06/11/2014
Last updated
07/03/2024
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