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Individual

DIANA BAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1534 PARK AVE, SUITE 210, QUAKERTOWN, PA 18951-1084
(267) 424-8850
(215) 538-7907
Mailing address
1534 PARK AVE, SUITE 210, QUAKERTOWN, PA 18951-1084
(267) 424-8850
(215) 538-7907

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
25MP00181700
NJ
363AS0400X
Surgical Physician Assistant
Primary
MA057632
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
140042NMS
MEDICARE PTAN
NJ
Enumeration date
09/11/2007
Last updated
05/31/2016
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