Individual
TONI JEN BASTATAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44-720 PUAMOHALA ST, KANEOHE, HI 96744-2449
(808) 349-6836
Mailing address
44-720 PUAMOHALA ST, KANEOHE, HI 96744-2449
(808) 349-6836
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
HI101017448
HI
Other
Enumeration date
06/28/2016
Last updated
06/28/2016
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