Individual
MARINA BASTAWROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
176 PALISADE AVE, JERSEY CITY, NJ 07306-1121
(201) 795-8200
Mailing address
129 S 20TH AVE, MANVILLE, NJ 08835-1639
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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