Individual
MRS. CRYSTAL LYN BASTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
321 E ALBANY ST, HERKIMER, NY 13350-2016
(315) 867-2700
Mailing address
354 OTSEGO ST, ILION, NY 13357-2512
(315) 894-4440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
021583
NY
Other
Enumeration date
10/25/2017
Last updated
10/25/2017
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