Individual
DR. NICHOLAS BASTIDAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 1ST AVE, IRPS, NEW YORK, NY 10016-6402
(212) 263-1059
Mailing address
550 1ST AVE, IRPS, NEW YORK, NY 10016-6402
(212) 263-1059
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
247535
NY
Other
Enumeration date
05/24/2008
Last updated
12/05/2013
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