Individual
DR. YOLANDA A. BASTAICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OE-008327-T
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001788218
PROMISE
PA
05
—
01788218
—
PA
01
—
08345
SPECTERA
PA
01
—
251841812
NVA
PA
01
—
27730
MEDICAL EYE SERVICES
PA
01
—
35034
AVESIS
PA
01
—
52381
DAVIS VISION
PA
01
—
BA673704
BLUE CROSS BLUE SHIELD
PA
Enumeration date
10/02/2006
Last updated
07/09/2007
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