Organization
BASTION MEDICAL PRACTICE OF NEW JERSEY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VASANTH KAINKARYAM MD (PRESIDENT)
(786) 220-0003
Entity
Organization
Contact information
Practice address
400 FARMINGTON AVE, FARMINGTON, CT 06032-1913
(650) 610-1617
Mailing address
400 FARMINGTON AVE, FARMINGTON, CT 06032-1913
(650) 610-1617
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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