Individual
ERICA RAE BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3900 N BUFFALO ST, WILLIAMSVILLE, NY 14221
(716) 656-4852
(716) 817-1779
Mailing address
425 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-5782
(716) 630-1219
(716) 817-1726
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
23 019956
NY
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
09/21/2016
Last updated
08/23/2018
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