Individual
MS. BIANCA BASTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
148-08 BROOKVILLE BLVD, ROSEDALE, NY 11422
(646) 256-8836
Mailing address
148-08 BROOKVILLE BLVD, ROSEDALE, NY 11422
(646) 256-8836
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
NY
Other
Enumeration date
03/07/2014
Last updated
03/07/2014
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