Individual
DR. ROBERT J BASTAICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
30 TRINITY POINT DR, WASHINGTON, PA 15301-2974
(724) 229-7769
(724) 229-7792
Mailing address
119 PORTER ST, WAYNESBURG, PA 15370-3605
(724) 998-1253
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
PA 6851-P
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007305570009
—
PA
Enumeration date
07/07/2006
Last updated
07/08/2007
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