Individual
GREGORY G. BASTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 MUNDY ST, WILKES BARRE, PA 18702-6830
(570) 824-0930
(570) 824-7755
Mailing address
150 MUNDY ST, WILKES BARRE, PA 18702-6830
(570) 824-0930
(570) 824-7755
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD034396L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1253055
—
PA
Enumeration date
08/30/2005
Last updated
02/25/2008
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