M,BASTAWROS,PHYSICIAN,P.C.
Managed Care Organizations at Seaview Ave, Staten Island, NY

License number
New York 126414
Category
Managed Care Organizations
Type
Exclusive Provider Organization
Owner
Name: DR. MARY N BASTAWROS MD
Title: PRESIDENT
Phone: (718) 668-3417
Address
Address
314 Seaview Ave, Staten Island, NY 10305
National Provider ID: 1720495328
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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M. BASTAWROS, PHYSICIAN, PC

314 Seaview Ave, Staten Island, NY 10305

Industry:
Medical Doctor's Office
Doing business as:
M Bastawros Physician PC
Registration:
Sep 20, 2013
State ID:
4461834
Business type:
Domestic Professional Corporation

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