Individual
MAFDY BASTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 E END BLVD, WILKES BARRE, PA 18711-0030
(570) 824-3521
Mailing address
6 MEADOWBROOK CT, WILKES BARRE, PA 18702-7835
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD428789
PA
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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